Unprofessional conduct by a health care provider

Our state licensed health care providers are held to the highest standards of professionalism. Whether licensed by the Texas Medical Board, the Texas Board of Nursing, or other licensing board, licensed health care providers have a duty to adhere to the rules of their specific board and Texas statues. If after an investigation the board determines that the licensee engaged in unprofessional conduct, the board will pursue disciplinary action.
Under the code, 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. This includes doctors, nurses, psychologists, chiropractors, dentists, and other health professions.

Unprofessional Conduct by a Health Care Provider

The Texas Occupations Code contains provisions applicable to health professions generally. Specifically, Chapter 105 addresses unprofessional conduct by health care providers. Understand that each licensing board has its own set of rules, and particularly its own set of rules codifying what behavior constitutes unprofessional conduct. It is imperative that health care professionals understand and adhere to the standards of expected of them.
Under the Texas Occupations Code, a health care provider commits unprofessional conduct if the health care provider, in connection with the provider’s professional activities:

  1. Knowingly presents, or causes to be presented, a false or fraudulent claim for the payment of a loss under an insurance policy (insurance fraud);
  2. 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;
  3. 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:
    1. Discloses to the patient, in writing, that the provider or the provider’s family member has a financial interest in the niche hospital; and
    2. 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 the revocation or suspension of a provider’s license, permit, registration, certificate, or other authority or other disciplinary action.” 3 Tex. Occ. Code § 105.002(b).
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 attorney immediately. Even if you believe the allegations are unfounded, you need to properly respond to the board and mount a strong defense.
Our firm help professionals, like you, keep their licenses when those licenses are under attack by a state agency or board.
BERTOLINO LLP represents licensed professionals across the entire State of Texas. To best serve our clients we have offices in Austin, Houston, and San Antonio. Our honest, experienced attorneys will fight aggressively on behalf of your medical license and reputation.
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