For New York physicians, pharmacists and other licensed professionals, an investigation by the Office of Professional Medical Conduct (OPMC) or the Office of the Professions' Office of Professional Discipline (OPD) can put a license, a practice and a reputation at risk. A single complaint can lead to a records request, an interview and, in some cases, charges. Early involvement of experienced counsel often shapes how the matter ends.

Understanding OPMC and OPD

OPMC, part of the New York State Department of Health, investigates complaints of professional misconduct against physicians, physician assistants and specialist assistants under Public Health Law § 230. Common triggers include patient care concerns, prescribing practices, impairment and billing issues.

OPD, part of the New York State Education Department's Office of the Professions, handles discipline for pharmacists, nurses and most other licensed professions under Education Law Article 130, including allegations of negligence, incompetence, moral unfitness and violations of practice rules.

The two offices can be involved in related matters, particularly where controlled substance prescribing and dispensing are at issue.

How an Investigation Typically Unfolds

Investigations usually begin with a complaint from a patient, an insurer, a hospital, a colleague or another agency. Timing varies widely, but the stages generally include:

  • Complaint review: the office decides whether the complaint warrants investigation.

  • Records request: you receive a letter requesting charts, prescriptions or other records by a stated date. How and what you produce matters.

  • Interview: investigators may ask you to discuss the matter. What you say becomes part of the record.

  • Resolution or charges: the matter may be closed, resolved by agreement, or proceed to formal charges and a hearing.

  • Review and appeal: adverse determinations can be challenged administratively and in court.

Responding without counsel, or not responding at all, can make the outcome worse. Professionals who engage experienced counsel early are better positioned to narrow the issues and pursue a measured resolution.

Common Allegations

  • Prescribing and dispensing: controlled substance prescribing or dispensing that is questioned under New York's controlled substance rules (10 NYCRR Part 80) and Prescription Monitoring Program requirements.

  • Patient care: allegations of negligence or substandard care, including dispensing errors.

  • Billing and fraud: upcoding, kickback concerns or false claims to Medicaid, Medicare or private payors.

  • Impairment: concerns about substance use or fitness to practice.

  • Recordkeeping: incomplete patient charts or controlled substance records.

  • Boundary violations: allegations that are serious even when unsubstantiated.

For pharmacies, issues found in a PBM or Medicaid audit can lead to a referral to OPD, turning a reimbursement dispute into a licensing matter. Telehealth prescribing has also drawn increased attention. Beyond the license itself, a disciplinary action can affect hospital privileges, payor contracts and professional reputation.

How We Defend You

  • Early response: retain counsel before answering the notice, and protect attorney-client privilege.

  • Building the record: assembling charts, policies, compliance logs and witness information that support your position.

  • Negotiation: many matters can be resolved before a hearing, and we pursue closure or a negotiated outcome where it serves you.

  • Experts: retaining physicians, pharmacists or practice management experts when the case calls for them.

  • Practice continuity: planning for coverage and operations while the matter is pending.

What You Can Expect

  • Prompt attention: we prioritize OPMC and OPD inquiries so deadlines are met.

  • Discretion: we protect your reputation as well as your license.

  • Statewide representation: from New York City to proceedings in Albany.

Prior results do not guarantee a similar outcome. Attorney Advertising.