Types of Disciplinary Actions

How state medical boards discipline physicians — from most to least severe

License Revocation or Suspension 32,980

Had license to provide health care revoked or suspended by a state licensing authority, or surrendered license while a formal disciplinary proceeding was pending.

238.3% of all serious actions
Conviction: Program-Related Crime 25,417

Convicted of a criminal offense related to the delivery of an item or service under Medicare, Medicaid, or other state health care program.

183.6% of all serious actions
Conviction: Patient Abuse or Neglect 8,033

Convicted of a criminal offense relating to neglect or abuse of patients in connection with the delivery of a health care item or service.

58.0% of all serious actions
Conviction: Healthcare Fraud 5,763

Convicted of a felony relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct in a health care program.

41.6% of all serious actions
Conviction: Controlled Substance 3,528

Convicted of a felony relating to the unlawful manufacture, distribution, prescription, or dispensing of a controlled substance.

25.5% of all serious actions
Managed Care Default 2,159

Default on health education loan or scholarship obligations, or default by managed care entity on contractual obligations.

15.6% of all serious actions
Entity Controlled by Sanctioned Individual 1,488

Entity owned or controlled by an individual who has been excluded, or who has a specified ownership or control interest in a sanctioned entity.

10.8% of all serious actions
Misdemeanor: Healthcare Fraud 931

Convicted of a misdemeanor relating to fraud, theft, embezzlement, or other financial misconduct in a health care program.

6.7% of all serious actions
Exclusion or Debarment by Federal Agency 804

Suspended or debarred under federal or state law from participating in any federal or state procurement or non-procurement program.

5.8% of all serious actions
Fraud, Kickbacks, or Prohibited Activities 728

Committed an act described in the anti-kickback statute, Stark law, or engaged in other prohibited referral or billing practices.

5.3% of all serious actions
Misdemeanor: Federal or State Program Fraud 331

Convicted of fraud or false claims in any federal or state program.

2.4% of all serious actions
Conviction: Program-Related Crime (Alt) 148

Convicted of a criminal offense related to the delivery of items or services under a federal health care program (alternative citation).

1.1% of all serious actions
Failure to Provide Items or Services 77

Failed to provide medically necessary items or services when obligated under federal health care programs.

0.6% of all serious actions
Misdemeanor: Controlled Substance 67

Convicted of a misdemeanor relating to the unlawful manufacture, distribution, or dispensing of a controlled substance.

0.5% of all serious actions
Peer Review Organization Recommendation 53

Excluded based on recommendation of a Peer Review Organization (PRO) / Quality Improvement Organization (QIO).

0.4% of all serious actions
Controlling a Sanctioned Entity 32

Individual who had a direct or indirect ownership or control interest in a sanctioned entity at the time of the conduct that was the basis for the sanction.

0.2% of all serious actions
Breach of Settlement Agreement 28

Breached terms of a prior settlement agreement with HHS OIG.

0.2% of all serious actions
Breach of Corporate Integrity Agreement 12

Breached terms of a Corporate Integrity Agreement (CIA) with HHS OIG.

0.1% of all serious actions
Failure to Supply Payment Information 12

Failed to supply requested information about payments or business transactions, subcontractors, or suppliers.

0.1% of all serious actions
Incorrect Billing for Physician Services 8

Excluded for a pattern of submitting claims or billing for services not provided as claimed.

0.1% of all serious actions
Making False Statements 2

Making false statements or misrepresenting material facts to federal agencies regarding health care matters.

0.0% of all serious actions
Failure to Grant Immediate Access 1

Failed to grant immediate access to OIG for audit, records examination, or program evaluation.

0.0% of all serious actions