Criminal Charges and Your Medical Licenses
For healthcare professionals in California, a criminal charge can have life-altering consequences. Beyond the risk of fines, restitution, or incarceration, criminal allegations can threaten your professional license and your ability to practice medicine. Physicians, nurses, pharmacists, and other healthcare providers are held to high ethical standards, and even an accusation of fraud or dishonesty can trigger a professional disciplinary investigation.
Below we discuss how understanding how criminal charges affect your medical license and taking early action to protect it are essential to safeguarding your career. If you are facing allegations or charges of healthcare fraud or white-collar financial crimes in Los Angeles, contact The Law Offices of Stanley L. Friedman in Beverly Hills to speak with a California board-certified criminal law specialist who specializes in healthcare fraud defense.
How Licensing Boards Respond to Criminal Allegations
California healthcare professionals are regulated by licensing authorities such as the Medical Board of California, California Board of Registered Nursing, Board of Pharmacy, and Department of Health Care Services (for Medi-Cal providers). These boards have a duty to protect the public and the integrity of the healthcare system.
When a provider is charged with or convicted of a crime, the licensing board typically conducts its own independent investigation to determine whether the conduct reflects unprofessional behavior, dishonesty, or moral turpitude. The outcome of a criminal case, whether a conviction, plea, or even a deferred judgment, can lead to disciplinary action such as probation, suspension, or revocation of the professional license.
Medical licensing boards are not bound by the outcome of the criminal court. Even if charges are dismissed or reduced, a board may still find that the underlying conduct violates professional ethics.
Crimes That Most Commonly Endanger Medical Licenses
While any criminal charge can raise red flags, healthcare-related and financial crimes receive special scrutiny from both prosecutors and licensing boards. These include:
- Healthcare billing fraud: Submitting false or inflated claims to Medicare, Medi-Cal, or private insurers.
- Kickback violations: Paying or receiving compensation for patient referrals in violation of the Anti-Kickback Statute or California’s Stark Law equivalents.
- False Claims Act violations: Knowingly billing for services not provided or misrepresenting diagnoses or procedures.
- Prescription and controlled substance fraud: Issuing prescriptions without medical necessity or diverting medications.
- Money laundering and financial fraud: Concealing or transferring funds obtained through fraudulent schemes.
These offenses are often prosecuted under federal law (such as 18 U.S.C. § 1347 for healthcare fraud or § 1001 for false statements) and may be accompanied by parallel civil or administrative actions. Even when criminal penalties are avoided through a plea or settlement, licensing authorities may impose their own sanctions.
Mandatory Reporting and Disclosure Requirements
California law requires most healthcare professionals to report criminal convictions to their respective licensing boards within a specified timeframe, often 30 days. Hospitals, insurers, and government agencies may also be required to report arrests or convictions, meaning boards frequently learn of alleged misconduct even if a provider fails to self-report.
Failing to report can worsen the situation. The omission itself may be treated as a separate ethical violation, compounding the disciplinary exposure. A prompt, accurate disclosure accompanied by a statement of context and remedial steps can demonstrate good faith and sometimes mitigate disciplinary outcomes.
The Disciplinary Process
Once notified of a criminal case, a licensing board typically begins an internal review, which may proceed as follows:
- Initial Investigation: The board gathers records from law enforcement, the courts, and insurers.
- Formal Accusation: If discipline appears warranted, the board issues an “Accusation” outlining alleged violations of the Medical Practice Act or related statutes.
- Administrative Hearing: The licensee can contest the allegations before an Administrative Law Judge (ALJ).
- Final Decision: The ALJ’s recommendation is reviewed by the board, which issues a final order that may include probation, suspension, or revocation.
Each stage offers opportunities to present mitigating evidence, such as compliance reforms, ethics training, and character references, that can influence the board’s decision.
The Importance of a Unified Legal Strategy
Healthcare fraud and white-collar criminal charges often trigger parallel investigations—one criminal, one administrative. Statements made in one forum can be used in another, and resolving one matter does not necessarily close the other.
This overlap makes it crucial to coordinate your criminal defense and licensing defense strategies from the start. A plea that seems advantageous in criminal court may still result in license revocation if it involves an admission of fraud or dishonesty. Conversely, a strong compliance response or internal audit may persuade regulators to view the case as a civil or administrative matter rather than a criminal one.
An experienced healthcare fraud defense attorney can communicate with both prosecutors and licensing boards to manage exposure, structure plea agreements to avoid mandatory license revocation, prepare a comprehensive mitigation package for the board, and advise on parallel proceedings, subpoenas, and self-reporting obligations. Early, coordinated legal representation is the best way to preserve both your liberty and your license.
Rehabilitation and Mitigation
California’s licensing boards have discretion to consider rehabilitation evidence before imposing discipline. A well-prepared submission might include:
- Proof of compliance reforms or ethics training
- Documentation of community service or continuing education
- Letters of recommendation from colleagues, patients, or employers
- Evidence that the alleged conduct was isolated and corrected
These materials can demonstrate that the provider has learned from the incident and poses no ongoing risk to patients or the public.
Healthcare Fraud Allegations: Unique Licensing Risks
Healthcare fraud prosecutions often involve complex billing regulations and subjective interpretations of medical necessity. What prosecutors characterize as “fraud” may in fact be billing errors, documentation lapses, or differences in medical judgment.
However, once fraud allegations are made, the consequences can reach far beyond the criminal case. A conviction, or even a civil settlement under the False Claims Act, can lead to mandatory exclusion from federal healthcare programs, effectively ending a provider’s ability to participate in Medicare or Medi-Cal. Boards may then move to revoke the provider’s license, citing unprofessional conduct or loss of federal eligibility.
An experienced healthcare fraud defense attorney can work to prevent a criminal case from escalating, challenge the government’s interpretation of billing practices, and negotiate outcomes that minimize collateral licensing damage.
Protecting Your Career and Your Future
When healthcare professionals are accused of criminal conduct, their livelihood hangs in the balance. The key to minimizing the damage lies in early, informed, and coordinated legal action.
At The Law Offices of Stanley L. Friedman, we understand that defending healthcare professionals requires more than criminal defense; it demands protection of their licenses, reputations, and professional standing. With extensive experience in healthcare fraud and white-collar criminal defense, our firm works to resolve investigations discreetly and effectively, always with an eye toward preserving our clients’ ability to continue practicing medicine.
If you are under investigation or have been charged with a healthcare-related offense in Los Angeles, do not wait until disciplinary action begins. Contact our office to discuss your situation and learn how we can protect both your freedom and your professional future.
