Expired License, Unfinished CE, and Three Weeks of Patients
Dr. Reyes has held a Maryland optometry license for 12 years. Her biennial renewal was due June 30. She completed 20 of the required 24 continuing education hours and did not submit the renewal because she was moving offices. She continued seeing patients from July 1 through July 22, examined 47 patients, signed 6 contact lens prescriptions, and billed insurers under her old license number. On July 23, a patient's insurer flags the expired license. Dr. Reyes calls the Board and says she 'didn't know' and asks whether she can keep seeing patients while she completes the remaining 4 CE hours online. She also asks whether she can backdate the renewal or have a colleague co-sign her charts.
1. What violations and risks arise from Dr. Reyes's conduct after June 30?
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Once the license expired, Dr. Reyes was no longer authorized to practice optometry in Maryland. Each of the 47 examinations, the 6 contact lens prescriptions, and the insurance billings under an expired license number is a separate problem. The conduct can support Board discipline for practicing without a license, and it may also create insurance-fraud exposure because the claims imply a valid license. 'I didn't know' may explain the lapse but does not cure it. The Board's authority includes investigating unlicensed practice and imposing sanctions such as reprimand, probation, suspension, or revocation, depending on the facts and mitigation. The optometrist should immediately stop seeing patients and stop billing until the license is restored. Continuing to practice while completing CE would compound the violation.
2. What steps must Dr. Reyes take to return to lawful practice?
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She should stop all clinical practice and prescribing immediately. She should complete the missing continuing education, obtain proof of completion, submit the renewal or reinstatement application with the required late fees, and cooperate fully with the Board. She should review her insurance contracts and correct or withdraw claims submitted during the lapse. She should also notify her malpractice carrier and seek advice about patient notification if any care was compromised. The Board may require an explanation, additional documentation, or a appearance before the Board before restoring the license. The reasoning is that licensure is a prerequisite to every patient encounter, not a paperwork formality; the remedy is prospective compliance and candor, not retroactive cover-up.
3. Evaluate her requests to backdate the renewal or have a colleague co-sign her charts.
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Both requests are improper. Backdating a renewal would falsify a licensing record and misrepresent the period during which she was authorized to practice. Having a colleague co-sign charts for care the colleague did not provide would falsify the medical record and could make the colleague complicit in unprofessional conduct. The proper response is to disclose the lapse, correct the record honestly, and let the Board determine what remediation is required. Co-signing is not a lawful substitute for supervision or for a valid license. The optometrist should document the lapse accurately and avoid any alteration that could be seen as deceptive.