An Example of the Resolution of An Insurance Company Audit of a Physician’s Billing
Navigating insurance company audit billing disputes—how we helped a provider cut a $350K demand through smart advocacy.
Read MoreNYC Healthcare Misconduct Defense Attorney
Navigating insurance company audit billing disputes—how we helped a provider cut a $350K demand through smart advocacy.
Read MoreRead this article to learn about how physicians should handle insurance audits and large repayment demands.
Read MoreLearn about some of the most recent OPMC & OPD issues that Walker Medical Law has been dealing with and contact our firm for assistance.
Read MoreRead four recent case studies from Walker Medical Law and contact us if you’re a physician accused of malpractice or negligence.
Read MoreRead this article by Paul Walker, Esq. to learn about how to negotiate with OPMC with a conviction of healthcare fraud in your background.
Read MoreIf you’re a physician and believe your hospital is about to terminate your employment, read on and contact our firm for help.
Read MoreRead on and reach out to Walker Medical Law to learn more about how to prepare for your OPMC hearing to have your medical license restored.
Read MoreAre you a healthcare provider with a substance abuse issue? If so, you must read on and contact our firm to learn about the steps to take.
Read MoreRead on to learn about how you can potentially have your medical license restored even after pleading guilty to a healthcare fraud felony.
Read MoreA List of Recent Outcomes in Office of Professional Medical Misconduct, OPMC, & Office of Professional Discipline, OPD, Cases A physician had two sexual encounters with a patient over a year after the patient was last treated by the physician. The matter was resolved with a non-disciplinary Administrative Warning for the physician. A nurse who […]
Read MoreRead on to learn more about how, with experienced representation, you can resolve OPMC and OPD disputes in an administrative warning.
Read MoreOn November 24, 2022, the New York State Survivors Act went into effect allowing lawsuits alleging sexual abuse to be brought regardless of how long ago the act occurred. This law is in effect until November 24, 2023, a one-year period, and already hundreds of lawsuits are underway. There are numerous law firms who are […]
Read MoreAre you a nurse practitioner looking to set a legally viable practice in New York? This blog explains how you can do so.
Read MoreBe forewarned that the New York State Justice Center may jeopardize your employment and medical license. Here’s why.
Read MoreIf you have pled guilty to any type of misdemeanor or felony charge regarding drunk driving, the Office of Professional Discipline is almost certainly going to discipline you in some manner because you have been found guilty of a crime. The fact that you now have a criminal conviction means that you are, by definition, […]
Read MoreThe Office of Professional Discipline, OPD, is the branch of the Department of Education that investigates and prosecutes medical licensees other than physicians and physician assistants. So, if you are a Registered Nurse, a Nurse Practitioner, a Podiatrist, a Psychologist, or other licensed health care provider, be very worried if you receive a letter from […]
Read MoreIf you are the target of a Department of Education, Office of Professional Medical Conduct, OPD, investigation, you must know how these investigations work to do your best to protect your New York State license whether you are a nurse, a podiatrist, a physical therapist or any type of health care professional other than a […]
Read MoreOver the last several years, we here at Walker Medical Law have encountered many physicians who are addicted to drugs or have been, incorrectly, accused of substance abuse. This, of course, is an enormously dangerous situation as any doctor who is not functioning at 100% of his/her mental capacity can be a danger to patients. […]
Read MoreMental health providers in New York State have an absolute duty to avoid any type of sexual advances or experiences with their patients. The word “providers” includes psychiatrists, psychologists, and social workers. When there is sexual contact, it is usually begun with subtle grooming of the patient by the provider. Words with double meanings are […]
Read MoreWhen a physician does not practice medicine in New York, but still has an inactive New York license, is disciplined by another state or pleads guilty to a crime, in another state, New York retains the ability to publicly discipline the physician. This is so because, in my view, New York wants to increase its […]
Read MoreOver the last two months, I have had three different physicians come to me with the same, neverending, story. That is, they were surprised by being summoned to go to the Human Resources office by a very officious person. They were told that they had to report at once. Upon arriving at the office they […]
Read MoreThis article will discuss several matters that have been dealt with by Walker Medical Law in the recent past. All of these issues should be instructive for professionals with medical provider licenses and will demonstrate how problems arise and how to try to deal with those problems once they are under investigation by the State […]
Read MoreWe recently concluded a negotiation with a physician and one of the health care insurance companies with which he has done business for years. This issue began, as most do, with a letter from the insurance company stating that they were asking that the doctor provide complete copies of the medical records of more than […]
Read MoreThe Office of Professional Discipline, OPD, is the enforcement arm of the New York State Department of Education and it has jurisdiction over the medical licenses of nurses, physical therapists, massage therapists, acupuncturists, and other non-physician and non-physician assistant licenses. When there is an issue concerning the conduct of one of these professionals, OPD has […]
Read MoreWhen a physician is going about looking to move to a new hospital or other medical organization, there is a period of good feeling when the doctor knows that he/she is wanted by the facility. This usually occurs during a series of meetings with people at the facility and everyone is polite, charming and, all […]
Read MoreWe represent individuals, including physicians, nurses, and other medical professionals, when they have to litigate against their long term disability insurance companies. The situation usually starts when the individual has been on disability and then receives a letter from the insurance company stating that for various reasons the person is no longer considered to be “disabled’ as that word is defined in […]
Read MoreWe have been notified by OPMC that an investigation of one of our clients is now completed and the case is now closed, with no further action. This was a very significant matter and the fact that OPMC has closed it without any findings of wrongdoing by our client is extremely gratifying as the matter was serious and the investigation […]
Read MoreWhen a physician decides to settle an issue with the office of professional medical conduct, (OPMC) there is often included in the Terms of the agreement some type of license restriction. This can be the inability of the physician to prescribe narcotics, the requirement that the physician has a chaperone, the need for a physician […]
Read MoreWhen the Office of Professional Medical Conduct, OPMC, investigates a physician, the matter can get to the stage where OPMC offers to “settle” the matter with a Consent Agreement. That means that OPMC will not prosecute the doctor, but the doctor will agree to some level of discipline. Many doctors are more than happy to […]
Read MoreENSURE YOU UNDERSTAND THE POSSIBLE DAMAGE TO YOUR BUSINESS AS A PHYSICIAN BEFORE SIGNING A CONSENT ORDER WITH THE NEW YORK STATE OFFICE OF PROFESSIONAL MEDICAL CONDUCT (OPMC) When OPMC investigates a physician, they often have to decide whether to conclude the case by accepting some level of discipline through a Consent Order. This decision […]
Read MoreOver the last few months, there have been numerous articles that discuss the fact that hospitals and doctors are suing their patients for payment of bills arising out of health care that was given. These situations arise in several different ways. Sometimes the patient has a surgical procedure and the surgeon’s bill is covered by […]
Read MoreWe recently were contacted by a physician who was named in a lawsuit along with perhaps 15 other doctors, hospitals, and clinics. This lawsuit is going to take years to come to an end and will cost everyone tens of thousands of dollars whether there is any merit to the claim or not. The physician […]
Read MoreAN ADDITIONAL UNPLEASANT RESULT FROM SIGNING A CONSENT ORDER WITH THE OFFICE OF PROFESSIONAL MEDICAL CONDUCT (OPMC) I recently was called by a physician who had experienced a very, very unpleasant bit of collateral damage after signing a Consent Order with OPMC. The Order called for a probationary period and a practice monitor who was […]
Read MoreIt all usually starts with a sudden demand that you, the physician, show up at an emergency meeting with either Human Resources or the chair of the department. There you are met with a very, very unpleasant discussion about your practice, with the upshot being that you have to resign from the hospital. The people […]
Read MoreBe careful if you are a physician doing work for a telemedicine company. We have recently represented physicians in two different cases involving telemedicine, and we think it is important to share the information gathered in those representations. Suffice it to say, this type of medicine can be very dangerous for the individual physician. These […]
Read MoreAll health care givers who work for a facility that is governed by the New York State Justice Center must be very careful when they become the subject of an investigation. The New York State Justice Center is an organization which investigates physicians, nurses, aides and anyone else who works in one of the facilities […]
Read MoreWhen you sign a consent order with the OPMC, it is essential that you understand and carry out the commitments in order. I recently was contacted by a physician who, in June of 2018, had signed a Consent Order with the New York State Department of Health, Office of Professional Medical Conduct, (OPMC). That Order […]
Read MoreWhen the Department of Health, Office of Professional Medical Conduct (OPMC) sends a physician a letter about an issue, that letter usually states that the medical practice of the physician is being “investigated”. That word, “investigated”, is extremely significant because it can lead to some very unpleasant consequences. The problem starts when the physician is […]
Read MoreWhether you are a physician or another type of health care provider, you are in a business relationship with health insurance companies that cover your patients. This proves to be true for those who are in their network and those that are an out–of–network provider. Although you welcome the checks that the companies send to […]
Read MorePhysicians today are at the mercy of health insurers because if you do not have a contract as a “provider” with the insurer then you might very well lose a substantial portion of your income. I just recently had a case where a major insurer wrote to a surgeon and advised that the contract between […]
Read MoreBe very careful when deciding what codes to use in billing an insurance company for your work. The company may report you to the state, claiming that you are committing fraud. Over the last few years I have represented numerous clients, physicians, dentists, dieticians, etc, in claims brought against them by health insurers on numerous […]
Read MoreIf you are a health care provider, a nurse, a chiropractor, a dentist, etc, all disciplinary hearings that could adversely affect your New York State license are held by the Department of Education, Office of Professional Discipline. The Hearings in the New York City area are held at 1411 Broadway, 10th Floor, New York, New York […]
Read MoreBE VERY CAREFUL ABOUT THE POSSIBLE UNINTENDED CONSEQUENCES FROM THE SIGNING OF A CONSENT ORDER WITH OPMC If you are a physician and the New York State Department of Health, Office of Professional Medical Conduct (OPMC), is threating to bring charges of unprofessional conduct against you, there is an understandable desire to put an end to the whole […]
Read MoreSOMETIMES YOU CAN ACTUALLY WIN AN OPMC HEARING AFTER YOU HAVE BEEN CONVICTED OF A CRIME We recently represented a physician who was convicted of a crime, violating a court order involving an Order of Protection, in another state. Any conviction, any felony or misdemeanor, is, by definition, unprofessional conduct and will result in The […]
Read MoreBE CAREFUL WHEN YOU GO TO AN INTERVIEW AT THE OFFICE OF PROFESSIONAL DISCIPLINE, OPD, –OTHER PEOPLE MAY HAVE GIVEN STATEMENTS TO PROTECT THEMSELVES AT YOUR CLIENT’S EXPENSE We recently represented a nurse at a Department of Education, OPD interview in a situation where it was claimed that regulations had not been followed when a […]
Read MoreI just finished a case where a health insurance company, HMO, notified my client, a physician, that it was claiming over-payments to the doctor and that he owed them a very large sum of money. The notice stated that he had to pay the overcharge within a very short period of time and if he […]
Read MoreA health care provider recently came to me after entering into a Consent Order with the Office of Professional Conduct, OPMC. The Order was lengthy and prevented the provider from practicing until certain steps were taken. One of the steps was to take and pass the certifying exam for Physician Assistants to prove that his […]
Read MoreYour client has his/her ability to practice medicine restored after a substance abuse rehabilitation, but does the clients board ccertification still exist? I recently represented a physician through a two plus year rehabilitation period and after a Hearing with the New York State Department of Health, The Office of Professional Medical Conduct, OPMC, the ability […]
Read MoreWhen a physician has been out of practice for some time due to substance abuse or other circumstances, OPMC will often make the attendance by the physician at a Clinical Competency Assessment program as part of the conditions necessary to permit the physician to return to the practice of medicine. At the end of the […]
Read MoreMany times a physician is faced with the option of signing some type of Consent Order with the Office of Professional Medical Conduct, OPMC, to put an end to an investigation. This is often done to avoid a possibly much worse result if the matter goes to a full blown hearing and the case is […]
Read MoreI routinely receive calls from physicians, nurses, and other healthcare providers about the answers to questions which are posed in the New York State licensure application. Sometimes the situation is when the application is in the process of being filed and the call comes to me when the State is questioning the truthfulness of some […]
Read MoreIn the years 2015 and 2016, I have seen a wide range of issues that came to me from physicians, nurses, and other healthcare professionals, all of which were potentially dangerous to the license of the individual client. I am going to list some of the matters in order to demonstrate what problems can arise […]
Read MoreIf you are a physician or other healthcare provider working at a hospital, you must be aware that the hospital administration is constantly looking to protect the hospital at the expense of its employees or independent attending physicians. Hospitals are constantly being monitored by the local, state and federal governments. If there is a problem, […]
Read MoreI have written on several occasions about the problems that can occur if a physician has a personal relationship with a patient. Most often this arises in the context of a romantic relationship between the doctor and the patient and it usually does not end well for the doctor. This short article chronicles a real […]
Read MoreThe purpose of this article is to educate physicians regarding the process of reinstating a medical license after surrendering it due to substance abuse. Suffice it to say, the road to the restoration is longer than you think it will be. What follows is the sequence of events in a case I just concluded. The […]
Read MoreBe careful of EMTALA and HIPAA violations If you are employed by or on the staff of a hospital, you must be very careful when dealing with or discussing patients. Two federal statutes that can truly make your life miserable are the Emergency Medical and Labor Act (EMTALA) and Health Insurance Portability and Accountability Act […]
Read MoreWe represented a physician who surrendered his medical license some years earlier due to several complaints of inappropriate behavior with some of his patients. One of the matters resulted in a criminal conviction. The physician wanted to have his license reinstated and we assisted him in preparing the required paperwork for the application. This consisted […]
Read MoreWhen you fill out your Registration Renewal form for your New York State medical license, read the questions very carefully. I have numerous cases where the physician answered some of the questions incorrectly. If that incorrect answer is discovered by The New York State Department of Health, the Office of Professional Conduct (OPMC), the office […]
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