When an HMO charges a physician with overcharging for services, the situation can become dangerous for the doctor.  At the worst, the HMO can report the doctor to the Department of Health with the charge of fraudulent billing.  If that happens, not only might the doctor have to repay a good deal of money to the HMO, but there will be an OPMC investigation to deal with.  The doctor needs to consider negotiating a settlement with the HMO to put  the matter to rest.

Settlements of medical malpractice cases are reported by insurance companies to the Department of Health.  Of course, the larger the settlement the more attention the matter will bring.  However, while OPMC can investigate any settlement, it usually begins to look at a physician more carefully if there are several settlements in a relatively short period of time.  This can be proof that the physician has a problem of some type, be it incompetence, a substance abuse issue or some other systemic difficulty that might put patients in danger.  Also, multiple settlements will be reported on OPMC’s website for the public to see.  So, be careful when you give your consent to settle a malpractice case as a payment may bring you up on OPMC’s radar screen.

If you were sanctioned by OPMC perhaps 15 years ago you might want to ask OPMC to remove the public sanction from its website.  The regulations say that OPMC must keep the sanction Order public for 10 years.  So, it would seem that OPMC has the discretion to take an old sanction Order off the website.  However, in my experience OPMC will simply not remove any Order.  I suppose you could go to court to say that OPMC is acting in an arbitrary fashion when it refuses to remove a very old sanction, but that would be expensive and I am not at all sure a court would substitute its judgment for that of OPMC.

Requests can be made but for the most part OPD will not remove a sanction unless there is truly a compelling reason.  You should try to have it removed, do not be surprised if the answer is no.

If you have lost your medical license in New York state, you truly have an uphill climb to have the license restored.  You really have to start the restoration process the day your license is revoked.  You can apply for restoration after three years from the date of revocation but you have to really be dedicated to do all of the things necessary to give yourself a fighting chance to have the license restored.  Please see my article on this subject.