Basics of the Texas Medical Board Informal Settlement Conference

An Informal Settlement Conference is not “informal” in the plain sense of the word. It is distinct from a Formal Hearing, such as a trial conducted at the State Office of Administrative Hearings, as it is not conducted on the record and does not allow for the presentation of witness testimony or extensive examination of the evidence. However, the “informal” designation should not cause a licensee of the TMB to take it lightly. The stakes are high. An informal conference is often the best opportunity to receive a dismissal or favorable outcome without litigating the case further at the State Office of Administrative Hearings.  Additionally, a favorable outcome depends greatly on the preparation of the licensee and their attorney and an understanding of what the TMB is looking for in each case. The attorneys at Lype, Dest & Smith have extensive experience in defending physicians and physician assistant clients at informal conferences with the Texas Medical Board. We understand the process, the necessary preparation, and how to best advocate for our clients in these proceedings.

The Path to an Informal Settlement Conference:

A complaint filed with the Texas Medical Board travels a common procedural path. First, the licensee is given an opportunity to respond to the initial complaint, which sometimes results in a quick dismissal of the allegations. If the complaint is not dismissed, it is sent to the TMB Investigations department, where additional information is gathered, including medical records and sometimes additional responsive material from the licensee. If the complaint involves allegations that the licensee violated the commonly accepted standard of care, the investigation also requires an “expert” review of the care provided. Sometimes, if it is clear to TMB staff that the complaint is unsubstantiated by the evidence, the case can be recommended for dismissal during the Investigation phase. If TMB staff believes there is probable cause to further investigate a complaint, it is shuttled over to the TMB Litigation Department and is set for an Informal Settlement Conference or “ISC”.      

Receiving Notice that You Have Been Scheduled for an Informal Settlement Conference:

Licensees are first notified that an informal settlement conference has been scheduled through a notice letter sent by the TMB. The initial notice is sent to the licensee well in advance of the scheduled conference and will state the date and time of the ISC. If the licensee has a conflict, they must request a continuance in writing and within five business days of receipt of the initial notice. At least 45 days prior to the ISC date, the TMB will send the licensee and their attorney a packet of materials detailing the allegations at issue and containing any supporting evidence to be used at the informal conference. At least 15 days prior to the ISC, the licensee may provide rebuttal material to be considered at the ISC. Given the limited amount of time allocated for the ISC meeting itself, it is extremely important to pre-file important evidence and argumentation before this deadline to ensure it is considered fully by the ISC Panel.

What to Expect at the Informal Settlement Conference:

Texas Medical Board informal conferences are conducted via videoconference. The Panel hearing the case is made up of two Board representatives- one layperson and one physician.  They are advised throughout the meeting by an attorney from the TMB’s general counsel’s office. The general counsel typically runs the meeting, is present for the entirety of the ISC, and is present with the ISC Panel during their deliberations. The general counsel does not have a vote as to the outcome of the matter, but is available to advise the Panel on the law and Board precedent. An attorney from the TMB’s litigation staff also attends the meeting in a role akin to a prosecuting attorney. They are responsible for presenting the allegations against the licensee.

The largest part of the meeting is turned over to the licensee and their defense counsel to present their defense. The ISC Panel, the general counsel, and the staff attorney may ask questions of the licensee.

After closing statements by the TMB staff attorney and defense counsel, the meeting is closed and everyone but the general counsel and the ISC Panel is removed from the meeting while the Panel deliberates. When deliberations are finished, the remaining participants are let back into the meeting to hear the recommendation for either dismissal of the case, resolution through a non-disciplinary Remedial Plan, or a recommendation for disciplinary action.

The Panel’s decision is termed a recommendation because the recommended outcome, whether dismissal or Agreed Order, must be ratified by the full Medical Board before it is effective.

If the Panel recommends dismissal, the case goes before the next Board meeting for approval. If the Panel recommends a Remedial Plan or Agreed Order, it will be reduced to writing by the staff attorney and the licensee will be given an opportunity to review and accept it or engage in further negotiations with staff. If the proposed action is unacceptable to the licensee and negotiations are unsuccessful, they have the option to reject the proposal, and the case will be filed at the State Office of Administrative Hearings to be heard before an Administrative Law Judge at a Formal Hearing.     

The Informal Settlement Conference is an extremely important event in the course of a TMB investigation. Due to cost and time factors, it is often the best opportunity to achieve a favorable resolution.

Need Legal Representation for an Informal Conference with the Texas Medical Board? Contact Lype, Dest and Smith today:

If you are a licensee of the Texas Medical Board with an active investigation, or if you are already in receipt of a notice for an Informal Settlement Conference, do not hesitate to contact the experienced Texas Medical Board license defense attorneys at Lype, Dest & Smith for a consultation.   

Darrin Dest

Darrin’s practices primarily in the areas of administrative and health care law, with a focus on the representation of professionals in front of their licensing boards and credentialing bodies. Darrin formerly worked for the Texas Medical Board and currently defends licensees.

Years of experience: 15 years
Bar numbers: 24065146
Location: Austin, TX