September 25, 2019

How to Respond to a Notice of Investigation from LARA


The letter is the beginning of a long process. The Code authorizes LARA to investigate activities related to the practice of a health profession by a licensee. This typically occurs once LARA receives notice of a potential violation of the Code (i.e. notice that a National Practioner Data Bank Report has been filed, a failure to renew your license timely, a failure to obtain required continuing medical education, etc.). It also occurs if someone sends LARA an Allegation form indicating that one or more grounds for disciplinary action exist. Anyone (e.g. patients, dental plans, etc.) may submit an Allegation form.

You should agree to meet with the investigator and have an attorney represent you. Your attorney should notify the investigator of his/her involvement and attend the meeting with you. You will likely learn then the cause of the investigation. During a consultation with your attorney you will determine exactly what to discuss and what documentation to produce. If requested or helpful, you may produce dental records. Both the Code and HIPAA allow this in connection with an investigation by LARA.

Following the meeting, the investigator may or may not request that you provide additional documents or other information. The investigator may or may not request a follow-up interview with you. LARA may also retain an expert to render a professional opinion regarding whether your conduct is consistent with the applicable standard of care or otherwise violates the Code. After the investigation, the investigator prepares and submits a written report to the Board of Dentistry. The Board uses this report to determine whether a violation of the Code occurred. The time required for LARA to complete its investigation and for the board to make its decision typically takes several months.

Board of Dentistry Determination

If the board determines there has been no substantiated violation of the Code you will receive written notice from LARA that its investigation has concluded and the file has been closed.

If the board determines there has been a violation of the Code, LARA will proceed to file an administrative complaint which you must answer within 30 days. You will then have an opportunity to request a compliance conference at which you and your attorney will meet with a representative of the board and/or an attorney from the Attorney General’s office. The compliance conference is a good opportunity to respond to the administrative complaint and negotiate a settlement. If a settlement is not reached, your case proceeds to a hearing before an administrative law judge. The judge will make determinations of fact and propose a decision to the board. The board then must decide whether to accept the decision of the administrative law judge. Only the board can impose sanctions against your license (suspension, revocation, probation, fine, etc.). The board’s decision can be appealed to the Michigan Court of Appeals.

The article can be viewed in the Journal of the Michigan Dental Association, on page 24.

Daniel SchulteDaniel J. Schulte answer questions about health care law has more than 25 years of experience helping clients solve tough problems and capitalize on opportunities that require a blend of business and legal expertise. His practice includes a focus on addressing the legal, business, licensing, and regulatory challenges of health care professionals, organizations, and facilities. Dan understands how legal issues impact business objectives and, as a result, offers his clients practical, results-oriented advice. He is experiences as a Certified Public Accountant, former managing partner and current executive committee member of the firm, and serves as co-chair of the firm’s Health Care Practice Group.

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Daniel J. Schulte

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Health Care Law