What Michigan Licensed Healthcare Professionals Need to Know About Reporting Their Criminal Convictions

It’s bad enough for anyone to have a criminal record. For licensed healthcare providers in Michigan, not reporting a conviction to your medical licensing board — and other healthcare entities — can very well lead to the end of your healthcare career.

Why? Because if you don’t report, you could get hit with penalties, fines, and disciplinary action ranging from license probation to full license revocation. These are not simply blemishes on your record; they irreparably damage your healthcare career.

And it doesn’t matter whether the charge has nothing to do with your practice (such as a DUI/DWI or domestic violence conviction), or if it is directly related (such as healthcare fraud or drug diversion). Your licensing board, employer, insurance carrier, and other administrative entities have a discipline process for all criminal convictions, as well as collateral consequences.

That’s why your criminal law and/or healthcare license defense attorney(s) handling your case must know from the outset whether you are a healthcare provider. By disclosing this early in the process, your attorney can make sure all the bases will be covered as your case goes on. At the same time, you should be aware of which boards and entities need to know about your criminal conviction — and when.

As the adage goes, the coverup is worse than the crime. If you’re a healthcare provider who could be facing a criminal conviction, here’s what you need to know in order to stay out of the “worse” category.

You need to be aware of the risks to your healthcare license if you have a criminal record.

First, there is a mandatory Summary Suspension for any felony conviction in the state of Michigan. Your attorney will make every attempt to negotiate with the prosecutor for a plea to a misdemeanor instead of a felony in the event that going to trial is not a viable option. However, should the prosecutor say no, a felony will lead to a licensing suspension as the matter progresses.

At times, a felony can be reduced to a misdemeanor, but in other situations, the prosecutor will only make a plea deal to reduce a felony to multiple misdemeanors. While having multiple misdemeanors could be better for your criminal record, this could be equal to a felony in eyes of LARA or the MDHHS.

Other repercussions to your license include:

• • Controlled Substance Felony Conviction: This is a five-year license revocation per the public health code; after five years, you may apply to have your license reinstated.
  • 4a (First-Time Domestic Violence Charge) and 7411 (Drug Possession): If you are convicted of either, one advantage is that it’s not considered a conviction under the public health code. However, someone such as an employer, an aggrieved family member, a former spouse, or someone else seeking “justice” could report that matter to LARA, which would prompt a licensing complaint and make the matter public record. In other words, while the conviction would “go away” on the criminal side, the administrative side could keep it alive via public record.
  • National Practitioner Data Bank (NPDB) Reporting Concern: The NPDB is a nonpublic database, where hospitals, insurance carriers, governmental entities, and licensing boards have access. This contains convictions related to the delivery of healthcare-related items or services, and they must be reported by the prosecutor.
  • Attempted Offense: While an actual assault can be pleaded down to attempted assault on the criminal side, LARA and MDHHS may still treat this as an actual offense for purposes of sanctioning your license or terminating Medicaid privileges.
  • Medicare/Medicaid Provider Exclusions: Depending on the severity of the conviction, you as a health care provider may not be able to bill Medicare/Medicaid, which will limit your employability down the road. For Medicare, the minimum exclusion period could be one to 10 years (per 42 U.S.C. 1320a-7) and for Medicaid, that period may be five to 10 years (MCL 400.111b through MCL 400.111e). These exclusion periods can be lengthened depending on the severity of the underlying offense.
  • Unemployment from Covered Facilities: One of the reasons why your attorney needs to know where you work is because you don’t want a plea to be entered that would render you unemployable by that facility. Certain healthcare facilities have workforce background checks, and if you work in one of the following facilities and you’re convicted, the time period bars range from one to 15 years, depending upon the conviction (per MCL 333.20173a):
    • Long-Term Care Facilities
    • Hospices
    • Psychiatric Hospitals
    • County Medical Care Facilities
    • Medicare-Certified Home Health Agencies
    • Swing Bed Hospitals
  • Fines: These can range from $250 to $250,000.
  • Probation: This is normally a single-page, quarterly reporting form through LARA, with particular conditions for which the convicted health care provider must comply.
  • Limitation: This can actually be a severe penalty for a licensee who bills Michigan Medicaid and private insurers, as it can result in not just placement on the MDHHS’s Michigan Medicare Excluder Provider List, but insurance carriers can also will exclude you.
  • Suspension: Anything more than six months and one day requires reinstatement of the license; anything below that time frame will have automatic reinstatement.
  • Revocation: For the most part, this is a three-year suspension, though felony controlled substance convictions will result in a five-year suspension. A permanent revocation is rare, such as in the Larry Nassar case.