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May 9, 2019

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Changing Trends in LARA Investigations

September 7, 2017

Over the years, Licensing and Regulatory Affairs (LARA) has conducted numerous investigations of physicians for one reason or another. However, in the recent months, investigations are being conducted on a more frequent basis than in the past. As a general rule, always have an attorney present during an interview with LARA. Not having an attorney present at the initial interview could be detrimental to you and could result in the filing of an Administrative Complaint putting the fate of your license in jeopardy.

 

Traditionally, in the realm of medical malpractices cases, we only saw LARA investigate settlements or judgments that were over $200,000. We also saw LARA investigate a physician when he/she had 3 or more malpractice settlements or judgements against them in a period of 5 consecutive years. This is because state law mandates investigation in these cases. However, state law allows LARA discretion to investigate other settlements and judgments as it sees fit. It appears LARA is instituting stricter guidelines in regards to its investigations of physicians following medical malpractice actions. Specifically, LARA has been trending towards investigating every physician following the entry of a settlement or judgment of any amount, however small, which has been entered in a medical malpractice action. In other words, if a physician has been named as a defendant in a medical malpractice matter, and a settlement or judgment is entered in any amount against that physician, LARA is likely to investigate.

 

Additionally, it is important to know that the Public Health Code mandates courts to report any entry of judgment or settlement of any amount in a medical malpractice claim. Not only are the courts mandated to provide information, but insurance companies are also required to furnish information regarding claims or actions for damages upon LARA’s request.

 

It is important to note that state law allows LARA to request information regarding cases and/or claims that may not have resulted in a monetary settlement. In other words, LARA can gain access to information on any cases and/or claims in which a physician was a party regardless of the outcome.

 

Typically, as part of its investigation LARA will call and request an interview. Should you receive a call from LARA requesting such an interview, you should promptly call your attorney. Going into an interview without an attorney present could be detrimental. For example, you could be entering the interview without medical records, essentially leaving you in the dark about the investigation. In addition, interviews with colleagues could have taken place or additional records could have been subpoenaed without your knowledge. An attorney can assist in setting ground rules for the interview, as well as ensure all relevant material is in your possession so that you can be adequately and appropriately prepared for the interview. This same rule of thumb applies regardless of whether LARA requests an interview following a settlement or judgment in a medical malpractice case or whether it is out of the blue. It is always within your best interest to have an attorney present during the interview as this will better enable you to avoid an Administrative Complaint being filed against yourself or a colleague.

 

Following the interview, LARA could choose to file an Administrative Complaint against you. Alternatively, LARA could choose to file an Administrative Complaint without first conducting an interview. In either scenario, it is within your best interest to have an attorney represent you. In the worst case scenario, an Administrative Complaint could end in your license being suspended or revoked, which would then require you to be reported to the National Practitioners Data Bank. This could be detrimental and could affect your credentialing, medical malpractice insurance, and many other aspects of your professional career. An attorney can help you avoid the worst case scenario.

 

The earlier the attorney is involved in the process, the better they are able to assist you. If you have been contacted by LARA for an interview, if you have been served with an Administrative Complaint, or if any questions or concerns, please contact the author, Megan R. Mulder of Cline, Cline & Griffin, P.C. at mmulder@ccglawyers.com or by calling the office at 810-232-3141.

1 MCL 333.12631(4) provides the two scenarios in which LARA is required to investigate a physician. MCL 333.12631(4) states: “If it receives information reported under section 16243(2) that indicates 3 or more malpractice settlements, awards, or judgments against a licensee in a period of 5 consecutive years or 1 or more malpractice settlements, awards, or judgments against a licensee totaling more than $200,000.00 in a period of 5 consecutive years, whether or not a judgment or award is stayed pending appeal, the department shall investigate.”

 

2 MCL 333.16243(2) states: “Within 10 days after the entry of a judgment against a licensee finding the licensee negligent in an action for malpractice or the approval by a court of a settlement in an action for malpractice, the clerk of the court in which the judgment was entered or the settlement approved shall prepare and immediately forward to the department on a form prescribed by the department a report setting forth the name of the licensee and the amount of damages awarded or the amount of the approved settlement.”

 

3 MCL 333.16243(1)(b) provides: “Information from an insurer providing professional liability insurance as to claims or actions for damages against a licensee; settlements in any amount; a final disposition not resulting in payment on behalf of the insured; or a personal injury claimed to have been caused by an error, omission, or negligence in the performance of the insured professional services. An insurer that receives a request under this subdivision shall submit the information requested directly to the department.”

 

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