Opinion ID: 2820086
Heading Depth: 3
Heading Rank: 2

Heading: As‐Applied Challenge

Text: Finally, we turn to Tsirelman’s claim that, even if use of the preponderance‐of‐the‐evidence standard is not on its face unconstitutional, its use in this case violated due process as applied to him because of the limited evidence from which the Hearing Committee could infer fraudulent intent. Tsirelman’s as‐applied challenge requires us to consider the particular facts of his case to determine whether the application of the preponderance standard, although constitutional on its face, deprived him of a protected right. See, e.g., Field Day, LLC v. Cty. of Suffolk, 463 F.3d 167, 174 (2d Cir. 2006). Tsirelman’s hearing did not deviate from normal hearing procedures in any material respect. In any event, the details of the necessary to Tsirelman’s position, that evidence of fraud in medical disciplinary hearings will necessarily be unreliable unless governed by formal rules of evidence. See United States v. Salerno, 481 U.S. 739, 745 (1987) (to sustain a facial challenge, “the challenger must establish that no set of circumstances exists under which the Act would be valid.”). Likewise, Tsirelman has failed to allege any facts suggesting the lack of formal rules of evidence resulted in an as‐applied due process violation. The Hearing Committee expressly acknowledged certain gaps in the evidentiary record and afforded Tsirelman the benefit of the doubt on any claims as to which “there was even a slight possibility” that additional information might have bolstered his position. In re Tsirelman, No. 07‐269, at 41, J.A. 232. And, as noted above, the Appellate Division annulled an entire subset of charges for which it concluded that additional evidence might have proven exculpatory. 15 No. 14‐2154‐cv hearing show that application of the preponderance standard did not deprive Tsirelman of due process because it did not unacceptably increase the risk of error. As the Appellate Division has already concluded, there was ample evidence from which the Hearing Committee could infer Tsirelman’s fraudulent intent, including discrepancies between patient medical records and the bills LaMed submitted to insurers, as well as Tsirelman’s “complete lack” of credible testimony. Tsirelman v. Daines, 876 N.Y.S.2d at 239. Tsirelman also availed himself of the robust procedures permitted in New York’s disciplinary hearings, including representation by counsel, presentation of evidence, witness testimony, and cross‐ examination of the State’s witnesses. Finally, Tsirelman obtained review of the Hearing Committee’s determination in an Article 78 proceeding. In sum, there is nothing exceptional about Tsirelman’s hearing that rendered the Hearing Committee’s use of the preponderance standard unconstitutional as applied to Tsirelman. In essence, Tsirelman asks us to reevaluate the Hearing Committee’s findings, but due process guarantees only a fair hearing, which Tsirelman received in full. See Conopco, Inc. v. Roll Int’l, 231 F.3d 82, 88 (2d Cir. 2000). Accordingly, the district court’s dismissal of Tsirelman’s as‐ applied challenge is affirmed. 16 No. 14‐2154‐cv