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Several Ways a New Jersey Doctor Convicted of Health Claims Fraud May Forfeit His Or Her License

In the course of my criminal defense practice, especially defending physicians accused of various crimes and violations, I’ve discovered that the next question after “what sentence will I receive?” is “what will happen to my license?” In fact, disciplinary proceedings conducted by the New Jersey State Board of Medical Examiners is the second in the list of nightmares faced by a New Jersey physician who is in trouble with the law. I’ve compiled some most frequently asked questions regarding licensing issues when a physician is accused of a crime in New Jersey.

Q. What happens to a professional license when the practitioner is convicted of a second-degree crime?

According to N.J.S.A. 2C: 51-5A, a New Jersey health care practitioner such as a doctor, who is convicted of a second degree health care claims fraud crime or a similar crime, will permanently forfeit his or her license and will never be able to practice the profession. The only way to prevent that is for the defense to argue that such license forfeiture would be a serious injustice, which overrides the need to deter such conduct by others. The court may consider another period of license suspension, but no less than one year. If you are lucky and the court does not permanently forfeit your license right away, the sentence is not final for 10 days so that the prosecution may appeal it.

When a practitioner is convicted of third degree health care claims fraud or a similar crime for the first time, there will be mandatory license suspension for at least one year. The second conviction will cost you your license for good.

Q. How will the licensing agency be notified of forfeiture or suspension?

A court will enter an order of license forfeiture or suspension immediately after a plea of guilty or finding the defendant guilty, assuming any of this happens in New Jersey. The order is effective as of the date of conviction r guilty plea. If it is an out of state or a federal conviction, or the defendant forfeited his license in another state, the court will enter the forfeiture order upon application of the county prosecutor or the Attorney General.

Q. May a license forfeiture order be stayed while the case is pending appeal?

An order of license forfeiture or suspension will usually not be stayed pending appeal of a conviction or forfeiture or suspension order unless the appellant’s attorney convince the court that there is a substantial likelihood of success on the merits. If the appeal is successful and the conviction is reversed or the order of license forfeiture or suspension is overturned, the court will notify the licensing agency within 10 days of the date of the order of reinstatement. That does not guarantee that the license will be restored because the agency, such as the New Jersey Board of Medical Examiners, may decide to suspend or revoke the license on its own motion.

Q. May a professional license be forfeited or suspended by a licensing agency?

Absolutely! This can be done through a special application by the Attorney General. The situation may arise in a case where the issue of license forfeiture or suspension is not even discussed raised in a court when the practitioner pleads guilty or is found guilty. However, the fact that a court has not ordered license forfeiture or suspension does not stop the licensing agency from doing that on its own accord. The decision may be based on the argument that the conduct giving rise to the conviction demonstrates that the person is unfit to hold the license or is otherwise liable for an offense.

Q. Can a professional or medical license be reinstated in New Jersey?

N.J.S.A. 2C:52-27.1(a) provides the procedure for reinstatement of forfeited professional licenses. If the conviction record is expunged, the convicted practitioner who lost his or her license as the result of conviction may ask the court for an order to rescind the court’s order of forfeiture if the person can demonstrate that he or she is sufficiently rehabilitated. If an order to rescind the court’s order of debarment is granted, the next step is to apply to the licensing agency for license reinstatement.