What is unprofessional conduct by a health care provider

Unprofessional conduct by a health care provider is grounds for discipline by the Texas licensing board of the provider. Providers licensed by the Texas Medical Board, the Texas Board of Nursing, or other licensing board, have a duty to adhere to the rules of their specific board and Texas statues. Our state’s health care providers are held to the highest standards of professionalism.

What is “Unprofessional Conduct” by a Health Care Provider?

Under Texas law, a health care provider commits unprofessional conduct if the health care provider, in connection with the provider’s professional activities:

  • Knowingly presents, or causes to be presented, a false or fraudulent claim for the payment of a loss under an insurance policy (insurance fraud);
  • Knowingly prepares or subscribes to any writing, with intent to present or use the writing, or to allow it to be presented or used, in support of a false or fraudulent claim under an insurance policy;
  • Knowingly directs or requires a patient to obtain health care goods or services from a niche hospital (a private, specialty hospital) in which the health care provider or an immediate family member of the provider has a financial interest, unless the provider:
    • Discloses to the patient, in writing, that the provider or the provider’s family member has a financial interest in the niche hospital; and
    • Informs the patient that the patient has the option of using an alternative health care facility.

3 Tex. Occ. Code § 105.002(a). Engaging in any of the unprofessional conduct described above constitutes cause for disciplinary action to be taken against the licensee.
Licensed health care professionals must adhere to the standards expected of them. This includes doctors, nurses, psychologists, chiropractors, dentists, and other health professions. A health care provider is defined as “a person who furnishes services under a license, certificate, registration, or other authority issued by this state or another state to diagnose, prevent, alleviate, or cure a human illness or injury.” 3 Tex. Occ. Code § 105.001.
In addition to the above rules on unprofessional conduct, health care professionals must also abide by the rules and regulations of their specific licensing board. If your licensing board notifies you that it’s investigating you for allegations of unprofessional conduct, it is critical that you consult with a medical license defense lawyer immediately. Even a single complaint filed with the Board can jeopardize your medical career, livelihood, and your professional reputation.
You have the right to defend yourself and the right to representation during the entire complaint process. Our attorneys know how to represent Texas doctors at every stage of the complaint process, from the initial investigation and any settlement negotiations through subsequent hearings that may follow.
BERTOLINO LLP represents licensed professionals across the entire State of Texas. Our honest, experienced attorneys will fight aggressively on behalf of your license and reputation. Contact us today or call (512) 476-5757 and schedule a case evaluation.
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