Disciplinary Action on a License

Disciplinary Action - Basics

Licensing boards can impose various types of disciplinary action on a professional license, regardless of whether the license is active, inactive, expired, or non-renewed.  Discipline consists of either a sanction on the license and/or a monetary penalty (i.e., a fine).

A board can impose the following sanctions on a license: Reprimand, Probation, Suspension, or Revocation. A board can also immediately suspend a license if it finds that the public health, safety, or welfare is in immediate jeopardy. This is called a "summary suspension" or "emergency suspension."

Boards can also impose a monetary penalty in addition to, or instead of, a sanction.  Monetary penalties vary in amount depending on the particular case, but are usually between $100 to $5,000.  In some cases, the penalty can be as high as $50,000.

Disciplinary Action - Additional Info

All sanctions and monetary penalties are imposed through either a Consent Order, or an Order, issued by the board.  An "order" is simply a written document issued by the board. It contains findings of fact, findings of law, and a description of the disciplinary action imposed by the board. 

A Consent Order results from a settlement in which both the licensee and the board agree to some type of sanction and/or monetary penalty.  A Consent Order takes effect when both the board and the licensee have signed the document.

An Order is an adjudication by the board in which the board imposes discipline and/or a monetary penalty without the agreement or consent of the licensee.  An Order is often issued following a show cause hearing or evidentiary hearing.

All disciplinary action is public, so it can be seen by employers, provider networks, credentialing entities, universities, schools, and anyone else who looks up the information online. Disciplinary action can negatively affect current or future employment and career opportunities.  For example, a current employer might terminate the licensee's employment.  Another example is when an insurance network finds out about the disciplinary action and then no longer allows the licensee to bill the insurance company for services provided to patients.

All disciplinary stays on your license permanently and cannot be expunged.

A licensee can surrender his or her license. If a licensee voluntarily surrenders a license, the licensee can no longer practice as of the date the surrender is accepted by the board.  After surrendering the licensee, the licensee becomes an unlicensed person.

A surrender of a license does not necessarily avoid the implications associated with sanctions on a license. When a license is surrendered, the licensing board notifies the National Practitioner Data Base, and the licensee may be placed on the Exclusion List and be prohibited from federal programs, employment, contracting, and funding (see below).

A surrender can also lead to termination of participation in insurance networks or provider groups.

Licensing boards in other states can also use the surrender to deny a license application, deny license renewal, or to impose a sanction on the license in that state.

Licensing boards usually post the surrender online. If that happens, anyone who looks up your license online can view the surrender document.

A licensing board can reject a surrender. If the surrender is rejected, it is often because the board wishes to pursue or impose some other type of disciplinary action on the license.

Effect of Disciplinary Action and Surrender on a License

When disciplinary action is imposed on a license or a license is surrendered, it can have additional consequences beyond the license itself.

Discipline against your Maryland license, or surrender of your license, can trigger discipline against your licenses in other jurisdictions, even if those licenses are active, inactive, expired, or non-renewed, and even if you do not live in that jurisdiction or never intend on practicing there again.

Licensing boards report all disciplinary actions and surrenders to the National Practitioner Data Bank (NPDB).  The NPDB is a national database, maintained by the U.S. Department of Health and Human Services, that maintains reports of certain adverse actions related to health care providers' licenses, privileges, and/or criminal history.

When a licensing board issues disciplinary action against a license, or a license is surrendered, the licensing board submits a report to the NPDB explaining what happened, and the disciplinary action imposed, among other things. For example, if a healthcare provider's license is suspended, the suspension is reported and logged into the NPDB.

Information in the NPDB is reviewed by insurance companies, provider networks, hospitals, universities and schools, and other entities.  A licensee can be denied participation in an insurance network, provider network, university, school, or a practice setting based on information contained in an NPDB report.

Under certain circumstances, a licensee can challenge the information submitted to the NPDB, or submit a response. Information submitted to the NPDB usually remains in the database permanently, with some exceptions.

The United States Office of the Inspector General monitors the NPDB and can put a licensee on the List of Excluded Individuals and Entities.  This means that the licensee is prohibited from participating in, or receiving money from, Medicare and Medicaid programs.  The licensee is also prohibited from working in any capacity for any entity that receives Medicare or Medicaid funds.  In some cases, a licensee can get a 30-day extension from being placed on the Exclusion List if there is a showing of certain mitigating circumstances.

Discipline and surrender can also result in the licensee being prohibited from receiving any money from government programs, or working for government agencies.  For example, the Government Services Administration may place the licensee on an exclusion list that prohibits the licensee from participating in various federal programs, employment, contracting, and receiving funding. The licensee may also be excluded from bidding as a subcontractor for government contracts. Another example is being excluded from taking part in a real estate closings when the home is financed by the Federal Housing Administration. Another example is denial of a reverse mortgage because it involves federal money.

It is important to recognize that employers may not want to employ individuals who have disciplinary action on their license, or keep them employed.  Some employers will terminate employment when they find out about disciplinary action.  Also, some employers will not hire you if they find out about disciplinary action on your license during pre-employment verification.

Discipline on a license, and surrender of a license, can each have other types of effects that simply cannot be predicted.