FAQs: Health Care Professional Licensing Board Complaint Investigations
Nearly 80 health-related occupations are regulated by state licensing boards in Minnesota. Some health-related licensing boards regulate a single occupation, such as the Board of Optometry, while others regulate a range of related occupations, such as the Board of Medical Practice. Each licensing board is charged with protecting the public from unsafe or incompetent practice by licensed professionals. To carry out this charge, licensing boards have broad authority to investigate and discipline professionals who are under their oversight. Typically, boards will carry out this authority through the complaint review process. This process can be very unfamiliar and overwhelming for licensed professionals who have never been involved in a licensing board investigation.
This post addresses several frequently asked questions relating to the licensing board complaint investigation process in Minnesota. Although many of the concepts will apply generally to all health-related licensing boards in the state, boards may follow slightly different processes and use different terminology. In addition, although some of these concepts are relevant to licensing boards in other states, this post is intended to address the process that applies to health care professionals who are licensed in Minnesota.
Who can file a complaint against a licensed health care professional?
A complaint can be filed by a patient, client, employer, other licensed professional or mandated reporter, or any other acquaintance of the health care professional. Certain licensed professionals and organizations are obligated to report licensee misconduct, but in many cases, a complaint originates directly from a patient or client. It is important to note that a patient or client does not need to be injured in order to file a complaint with a licensing board. Rather, a patient or client can report any concerns regarding a health care professional’s conduct. A licensing board is statutorily obligated to investigate complaints to determine whether the licensee violated the relevant practice act or board regulations.
What conduct can trigger a complaint to a licensing board?
Complaints can be triggered by a wide range of conduct, but in order for the conduct to rise to the level of disciplinary action by a licensing board, the conduct must be in violation of a practice statute or regulation applicable to a licensee.
According to the Board of Medical Practice (“BMP”), most complaints the BMP receives and investigates are related to the following concerns:
Failure to provide appropriate medical care or other competency issues;
Inappropriate prescribing of medications or controlled substances;
Inappropriate, unethical or improper conduct;
Conduct that departs from or fails to conform to the minimal standards of acceptable and prevailing medical practice;
HIPAA violations;
Informed consent issues;
False or misleading advertising;
Impairment or inability to practice medicine due to intoxication, use of drugs or narcotics, mental illness, or diminished physical condition or cognitive ability;
Failure to maintain adequate medical records or inaccurate medical documentation;
Engaging in abusive or fraudulent billing practices; and
Engaging in sexual conduct with a patient.
How does a licensing board inform a licensee that they are being investigated by the board?
When a licensing board receives a complaint against a licensee, the board will initiate an investigation and will send the licensee a letter describing the allegations contained in the complaint. The board’s letter will summarize the allegations and request the licensee to respond to the allegations within a specified period of time.
What should a licensee do when they receive a complaint investigation letter from a licensing board?
It is important for the licensee to promptly and thoroughly respond to the allegations by submitting a response to the board in a timely manner. If the licensee is unable to meet the response deadline specified in the letter, they should reach out to the board to request an extension. It is in the licensee’s best interest to engage legal counsel at this point in the process to assist with the response and any follow-up proceedings with the board. Legal counsel can help the licensee frame the issues, anticipate challenges, and ensure that the response is thorough and appropriate. Legal counsel can also assist with future communications with the licensing board if the board requests additional information or if the investigation proceeds to a hearing (described below).
What should the licensee’s response include? Can a licensee provide patient medical records to the licensing board?
The licensee’s response should fully address the allegations raised in the complaint and should include all corresponding documents requested by the board. This may include copies of patient or other records, such as informed consent forms, diagnostic images, etc. In some cases, the board will have received a written consent from the patient permitting access to the patient’s records. However, if the board’s letter states that such consent is not available, the licensee will need to delete any information in the record that identifies the patient before providing it to the board (See Minn. Stat. § 147.161, subd. 3; Minn. Stat. § 148.265).
Will the licensee be required to appear before the licensing board?
In some investigations, complaints will be dismissed after the licensee submits a written response to the allegations, and the licensee will never have to meet with the licensing board. In other cases, the board will request the licensee to appear before the complaint review panel or committee. This is the body that reviews the complaint and the licensee’s response, gathers information, and recommends whether to pursue disciplinary or corrective action against the licensee. If the complaint review panel/committee decides a meeting is necessary, it will require the licensee to appear before the panel/committee to further respond to the complaint allegations. If the licensee has legal representation, their lawyer can also attend this conference and assist the licensee with preparing for the meeting.
What are the potential outcomes of the board’s investigation?
After reviewing the information and, if necessary, meeting with the licensee, the complaint review panel/committee may take any of the following actions:
Dismissal of the complaint;
Continuance, pending further investigation or other specified action;
Corrective action (often educational) without formal discipline; or
Disciplinary action.
What kind of disciplinary action can the licensing board take against a licensee?
If the licensing board determines that the license has violated state statutes or regulations governing the practice of their profession, the board may impose disciplinary actions such as the following:
Suspend a license;
Revoke a license;
Refuse to grant or renew a license;
Impose limitations or conditions on a licensee’s professional practice (e.g., require completion of specific reports or evaluations);
Order a licensee to pay a civil penalty;
Publicly censure or reprimand a licensee;
Require a licensee to practice under supervision or with other oversight;
Order a licensee to stop treating certain illnesses or stop performing certain procedures;
Require a licensee to participate in the Health Professionals Services Program; or
Require a licensee to complete additional education.
Do all complaints result in disciplinary action?
No. A licensing board can only take disciplinary action against a licensee if, after reviewing all the information presented in connection with a complaint, the complaint review panel/committee determines that the license’s conduct violated state statutes or regulations enforced by the board. If the complaint review panel/committee determines there is enough evidence to establish that the licensee violated such statutes or regulations, the panel/committee can recommend disciplinary or corrective action as described above.
If the complaint review panel/committee recommends disciplinary action, it will ask the licensee to agree to place restrictions on their license by voluntarily entering into a Stipulation and Order. If the licensee refuses to agree to the proposed Stipulation, or if the larger board disagrees with the Stipulation, the matter may proceed to a contested case hearing. This hearing is held before an Administrative Law Judge (“ALJ”) pursuant to the procedures of the Administrative Procedures Act. The hearing is similar to a civil trial and involves the presentation of testimony and submission of exhibits. The ALJ will issue an opinion based on the evidence presented during the contested case hearing, and the licensing board will make a final determination, which may or may not override the ALJ’s recommendation. If the licensee still disagrees with the board’s determination, the licensee can appeal to the Minnesota Court of Appeals.
Is the complaint and investigation confidential?
While the licensing board is investigating the matter, all information relating to the complaint allegations and the board’s investigation will remain confidential. At this point in the process, it is important for the licensee to limit the disclosure of information about the investigation and complaint allegations except as needed to respond to the board. However, if the board imposes disciplinary or corrective action against a licensee, this information is available to the public, including any Stipulation and Order issued in connection with the matter.
How long does the complaint review process take?
The length of the complaint review process can vary significantly depending on the particular licensing board involved, the volume of complaints received by the board, the complexity of the complaint, and the type of investigation required. Some complaints take months, while others take years. For example, the BMP reported that, as of June 2024, approximately 28% of the BMP’s outstanding complaints had been open longer than one year (303 complaints out of 1,053 total open complaints). By contrast, approximately 10% of the Board of Nursing’s outstanding complaints had been open longer than one year (91 complaints out of 871 total open complaints).
Does a licensee need to disclose a complaint to an employer and/or to other boards that license them?
As explained above, the complaint allegations and details regarding the licensing board’s investigation are confidential during this phase of the process, and in most cases, a licensee is not obligated to share this information with their employer. However, in some cases, they may need to inform their employer of the investigation (for instance, if their employment agreement requires notification of any such investigation).
If a licensee is applying for licensure in another state, or if they are already licensed in another state and their application is up for renewal, the license license application or renewal form may ask if the licensee is under investigation by any other licensing board. In this case, the licensee will need to disclose the ongoing investigation. It is helpful to work with a lawyer who can help prepare any such response.
Does a licensee need to engage a lawyer if they are under investigation by a licensing board?
A licensee is not obligated to be represented by a lawyer in connection with a licensing board investigation. However, it can certainly be in their best interest to work with an experienced attorney who can assist them with preparing a response to the complaint allegations, communicating with the board, and preparing for a contested case hearing, if needed. Because the licensee’s professional license and reputation are at stake, having competent representation is critical.
If you need assistance with a licensing board investigation, London Legal Consulting, LLC can assist. Please contact us today.