Authority to Discipline Physicians in Maryland

Under the Medical Practice Act ("the Act"), the Board has authority to discipline physicians for enumerated reasons. Section 14-404(a) identifies 40 specific bases for disciplinary action, two of which explicitly pertain to conduct committed "in the practice of medicine." Section 14-404(a)(3) permits the Board to discipline a licensee who "is guilty of immoral or unprofessional conduct in the practice of medicine." Section 14-404(a)(11) authorizes discipline of a physician who "willfully makes or files a false report or record in the practice of medicine." In addition, section 14-404(a)(22) allows disciplinary action against a licensee who "fails to meet appropriate standards as determined by appropriate peer review for the delivery of quality medical and surgical care performed in a . . . hospital." In Md. Bd. of Physicians v. Bernstein, 167 Md. App. 714, 719-21, 894 A.2d 621 (2006), the Court detailed the Board's process for investigating and adjudicating complaints against physicians, and the ensuing process of judicial review. The Act authorizes the Board to reprimand a licensed physician, place a licensee on probation, or suspend or revoke a license to practice medicine for enumerated reasons . . . . When an allegation that may constitute grounds for disciplinary action under the Act comes to the Board's attention, the Board generally initiates an investigation. HO 14-401(a); COMAR . If the allegation concerns the standard of care and, after an investigation, the Board elects to pursue further investigation, the Board then refers the complaint to the Medical and Chirurgical Faculty of Maryland ("Med Chi") physician peer review. HO 14-401(c)(2); COMAR The Board and Med Chi have adopted a "Peer Review Handbook" that governs the peer review process. Med Chi prepares a report addressing the allegations against the physician and submits it to the Board. After receiving the Med Chi report, the Board determines whether reasonable cause exists to charge the physician with a failure to meet appropriate standards of care. COMAR If the Board files a charge, it refers the matter to an administrative prosecutor and sends notice to the physician. COMAR At that point, the physician is entitled to a contested case hearing before an administrative law judge ("ALJ"), in the Office of Administrative Hearings ("OAH"), pursuant to the Administrative Procedure Act, Md. Code (1984, 1999 Repl. Vol. ), section 10-201 et seq. of the State Government Article ("SG"). HO 14-405(a); see also COMAR Following the hearing, the ALJ issues findings of fact, conclusions of law, and a proposed disposition. COMAR . . . Either party may file exceptions to the ALJ's findings and proposed disposition. COMAR The Board is not bound by the decision of the ALJ. After receiving the ALJ's proposed decision, the Board must review the record and the ALJ's proposal, and hold a hearing on any exceptions. COMAR It then issues a final decision stating its findings of facts, conclusions of law, and a disposition of the charge. COMAR The Board's final decision is subject to judicial review in the circuit court in accordance with the Administrative Procedure Act, and then to appeal to this Court. HO 14-408(b). (Footnotes and some citations omitted. ) See also Md. Bd. of Physicians v. Elliott, 170 Md. App. 369, 907 A.2d 321 (reviewing standards for appellate review of Board decision overruling ALJ), cert. denied, 396 Md. 12, 912 A.2d 648 (2006).