Opinion ID: 1908230
Heading Depth: 1
Heading Rank: 2

Heading: Statutory Construction Issues

Text: The two statutory construction issues interrelate; both stem from the alleged ambiguity arising from the fact that the conduct underlying Felsenberg's conviction might (or would) itself be grounds for discipline under one or more provisions in § 14-404(a). The question, precisely, is whether the Legislature intended for the conviction of a crime involving moral turpitude based on conduct subject to discipline under subsection (a) to be dealt with, exclusively, in accordance with subsection (a), rather than under subsection (b). In this context, where the issue depends less on the meaning of particular words or phrases than on the interplay between separate provisions, legislative history is a particularly fertile source for determining the legislative intent. In 1888, to promote the public health and regulate the practice of medicine, the Legislature, apparently for the first time, required persons practicing medicine either to be a graduate of a legally authorized medical college or, if already practicing medicine, to complete such examination as the State Board of Health chose to give. If the person either had a proper diploma or passed the examination, the board issued a certificate, which entitled the person to practice medicine. Section 7 of the Act authorized the board to deny a certificate to individuals guilty of unprofessional or dishonorable conduct or of criminal practice and to revoke certificates for like causes. 1888 Md. Laws, ch. 429. In 1892, the Board of Health was replaced as the licensing agency by two separate boards of medical examinersone representing and appointed by Med Chi and one representing and appointed by the Maryland State Homeopathic Medical Society of the State of Maryland. Either board could grant a license to practice medicine upon proof of graduation from a medical college and passage of an examination given by that board. Although the Act required that an applicant be of good moral character, it did not include the provision in the 1888 law permitting the board to deny or revoke a license upon proof of unprofessional or dishonorable conduct or criminal practice. 1892 Md. Laws, ch. 296. A provision of that kind was restored in 1902, when the Legislature authorized the two boards to revoke a license for fraud or deception in passing the examination, habitual drunkenness, criminal abortion, conviction of a crime involving moral turpitude, or unprofessional or dishonorable conduct. 1902 Md. Laws, ch. 612. It was thus the 1902 law that first articulated the authority to revoke a license to practice medicine upon conviction of a crime involving moral turpitude, as opposed to the more general ground of criminal practice. The law specified, however, that, before revoking a license, the board had to furnish the doctor with a copy of the charges and afford the doctor the opportunity for an evidentiary hearing. A decision to revoke a license was subject to judicial review. That structure lasted until 1957, when the Legislature did away with the board representing the Homeopathic Medical Society and created one Board of Medical Examiners, all the members of which were selected by Med Chi, as the licensing agency. 1957 Md. Laws, ch. 29. The provisions regarding the revocation of licenses were left more or less intact, except that (1) insanity and addiction to narcotics were added as grounds for revocation, and (2) both the doctor and the board were authorized to appeal a decision of the circuit court, made on judicial review, to this Court. There was no provision, in either the 1902 law or the 1957 law, permitting the suspension of a licenseonly revocation following the opportunity for a hearing. The authority to suspend a license and place a physician on probation was added in 1966. 1966 Md. Laws, ch. 209. In 1968, the Legislature once again restructured the agency and, along with that restructuring, added several new grounds for suspending or revoking a license. 1968 Md. Laws, ch. 469. In place of the Med Chi-appointed Board of Medical Examiners, it created a nine-member Commission on Medical Discipline. Seven members were to come, directly or indirectly, from Med Chi, the Governor being free to appoint two other physicians. A new provision, however, required the commission to refer all cases coming to its attention to either Med Chi or the appropriate county medical society for investigation and report. The report was to contain such recommendations as the investigation reveals might be necessary for adequate disciplinary procedures, and the commission was then to consider those recommendations. When the commission completed its investigation according to the process outlined herein, it was authorized to dismiss the charges or to reprimand a physician, place him or her on probation, or revoke or suspend the license, for any of 18 enumerated reasons. Among those reasons were conviction of a crime involving moral turpitude, willfully making and filing false reports or records in the licensee's practice as a physician, and the filing of false statements for collection of fees for which services are not rendered. If the physician sought judicial review of an order suspending or revoking a license, the order was automatically stayed until final judgment was entered. In 1970, the General Assembly split the licensing and disciplinary functions, creating an eight-member Board of Medical Examiners to handle the former and a nine-member Commission on Medical Discipline to handle the latter. 1970 Md. Laws, ch. 736. Med Chi remained in control of both agencies, electing all eight of the board members and having seven of the nine commissioners appointed directly or indirectly from its ranks. As in the preexisting law, all cases coming before the commission had to be referred for investigation to Med Chi or to a county medical society, and the commission was authorized only to act upon the report and recommendations made by that body. The grounds for discipline remained essentially the same as were included in the 1968 Act, and, as before, any order of the commission suspending or revoking a license was automatically stayed pending judicial review. By 1988, it became clear that the disciplinary scheme then in effect was unsatisfactory, leading the Governor to sponsor comprehensive legislation (Senate Bill 508) to change both the structure of the regulatory agencies and the procedures for disciplining errant physicians. Testimony before the Senate Economic and Environmental Affairs Committee indicated that, due to the multiple referrals between the commission, Med-Chi, the Attorney General's Office, and the county medical societies, which created a complex flow-chart, it took approximately 11 months to dispose of the average consumer complaint and 15 months for final action on serious complaints. Those delays had produced a significant backlog of unresolved complaints against physicians. According to the Governor's Office, 695 cases were then being investigated by the commission and another 590 cases had been referred to the commission but had not yet been preliminarily reviewed and referred to Med Chi or a county medical society. See Senate Economic and Environmental Affairs Committee Bill Analysis on Senate Bill 508 (1988). The bill did away with the two existing boards and replaced them with a new 15-member board, ultimately named the Board of Physician Quality Assurance, to perform both the licensing and disciplinary functions. Additional assistance from the Attorney General's Office was provided for, and, although the board was permitted to refer any case to Med Chi for investigation and peer review, it was required to refer to Med Chi only those cases involving standards of medical care, and then only after making its own preliminary investigation. The Legislature expressed its intent that all cases be resolved as expeditiously as possible and, in any event, within one year. 1988 Md. Laws, ch. 109. A key feature of the bill, which remained intact throughout the legislative process, was the one at issue here. Section 14-504(a)(6) of the then-current law, authorizing the board to discipline a physician upon conviction of, or a plea of guilty or nolo contendere to, a crime involving moral turpitude, was repealed in favor of new § 14-504(b), requiring a suspension upon conviction or plea and a revocation after completion of any appellate process. That feature was highlighted in the testimony of both the Secretary of Health and Mental Hygiene and the Governor's Legislative Officer and also in the Revised Fiscal Note prepared by the Department of Fiscal Services. It was consistent with a model Medical Practice Act prepared by the Federation of State Medical Boards of the United States, of which the General Assembly had a copy. Section X of that model Act stated that the disciplinary board should be authorized to summarily suspend a license prior to a formal hearing when ... a licensee is convicted of a gross misdemeanor or felony, whether or not related to the practice of medicine, or enters a guilty or nolo contendere plea to a gross misdemeanor or felony charge. The Legislature did not then go so far as the model Act recommended. Under the existing law, a doctor charged with having been convicted of a crime of moral turpitude was entitled to a contested case hearing before his or her license could be suspended or revoked. The 1988 legislation retained that right, although all hearings were to be before a hearing officer rather than the board itself. As enacted, § 14-504(b)(1) stated that [s]ubject to the Administrative Procedure Act, the board shall order the suspension of a license if the licensee is convicted of.... That changed two years later. By 1990 Md. Laws, ch. 237, the General Assembly deleted the introductory language in § 14-504(b)(1) and replaced it as follows (brackets indicating deletions and capitals indicating new language): [Subject to the Administrative Procedure Act] ON THE FILING OF CERTIFIED DOCKET ENTRIES WITH THE BOARD BY THE OFFICE OF THE ATTORNEY GENERAL, the Board shall.... The bill enacting that amendment was proposed by the Department of Health and Mental Hygiene. Its intent, as expressed in the Bill Analysis prepared by the Senate Economic and Environmental Affairs Committee, was to repeal the requirement that the Board hold a separate administrative hearing when the Board formally charges a licensee who has been convicted of a crime of moral turpitude and allows the Board to charge the licensee on the submission of Certified Docket Entries by the Office of the Attorney General. See Senate Economic and Environmental Affairs Committee Bill Analysis of Senate Bill 138 (1990). The Bill Analysis noted that, under the existing law, the board was required to formally charge a licensee who has been convicted of a crime of moral turpitude in a court of law, conduct a hearing, and decide on the appropriate disposition of the case and also had to hold a separate administrative hearing on the issue. The proposal, it said, simplifies the current procedure by authorizing the Board to act based solely on the submission of Certified Docket Entries by the Office of the Attorney General. The 1990 amendment put § 14-404(b) into its present form. There have been a number of amendments made since to § 14-404(a), but none of them changed what is now § 14-404(a)(3), (11), (21), or (23)the paragraphs urged as being germane to this case. The legislative history recounted above reveals a number of significant things relevant to Felsenberg's complaint of an inconsistency or conflict between § 14-404(a) and (b). As far back as 1888, the law allowed a physician's license to be revoked for either unprofessional or dishonorable conduct or criminal practice. It was possible, even then, if a doctor was convicted of a criminal offense that also constituted unprofessional or dishonorable conduct, to revoke the license either for the criminal conduct, established by the conviction, or for the underlying conduct, which would have to be proved in an administrative proceeding. Except for the ten years between 1892 and 1902, that ability to charge alternatively has remained in the law. The particular overlap complained of here has existed since 1968. As noted, the law has allowed a license to be revoked upon conviction of a crime involving moral turpitude since 1902; in 1968, the Legislature authorized suspension or revocation upon a showing that the licensee filed false statements for collection of fees for which services were not rendered. Had Felsenberg's conviction of mail fraud, based on mailing false statements for the fraudulent purpose of collecting fees for services not rendered by him, occurred between 1968 and 1988, he could have been charged with the conviction, with the underlying conduct, or with both. Had he been charged only with the conviction, the disciplinary agency would have been obliged to refer the matter to Med Chi and await a report from that society, but the only issues that likely could have been generated were those raisable under the current law: (1) whether there was a conviction; (2) whether Felsenberg was the person convicted; and (3) whether the crime was one involving moral turpitude. All that the Legislature did through the 1988 and 1990 legislation was to carve out that limited category for expedited and summary disposition. It recognized in 1988 that, when the charge rests solely upon the conviction, there is no need to inquire into the underlying conduct and therefore no need for a referral to Med Chi. In 1990, it went further and determined that, in light of the limited scope of the issues raisable under such a charge, there was ordinarily no need for a mandated contested case hearing of any kind. The first two issueswhether there was a conviction and whether the licensee was the person convictedare rarely contested and, if contested, are usually resolvable through documentary evidence. The very predicate of § 14-404(b)(1) would necessarily require at least a limited hearing if there is, indeed, a genuine dispute as to those issues, and, as noted, the COMAR regulations provide for an evidentiary hearing in that event. Here, of course, there was never any dispute that Felsenberg was convicted. Whether the crime is one involving moral turpitude is an issue which ordinarily may be resolved without the need for evidence or fact-finding. The intent of the Legislature in directing summary treatment of a charge based on the conviction of a crime involving moral turpitude is clear. Although there may, in given circumstances, be an overlap, in that a charge could be brought under either subsection, we see no conflict or inconsistency between the two, and certainly none that would require declaring subsection (b) unenforceable. The fact that particular conduct is proscribed by two or more statutes does not mean that there is a conflict between them; nor does it ordinarily preclude a prosecution under any one of the statutes that applies, notwithstanding that the procedures or penalty applicable to that statute are more onerous than under another applicable statute. See DiBartolomeo v. State, 61 Md.App. 302, 486 A.2d 256 (1985) (person alleged to have committed fellatio can be charged with common law sodomy, statutory perverted practice, or statutory sex offense). The prevailing rule was well-stated in Davis v. United States, 385 A.2d 757, 759 (D.C.1978): A defendant has no constitutional right to elect which of two applicable statutes will form the basis of his indictment and prosecution. See also United States v. Greene, 489 F.2d 1145 (D.C.Cir.1973), cert. denied, Greene v. U.S., 419 U.S. 977, 95 S.Ct. 239, 42 L.Ed.2d 190 (1974); U.S. v. Mitchell, 39 F.3d 465 (4th Cir.1994), cert. denied, Mitchell v. U.S., 515 U.S. 1142, 115 S.Ct. 2578, 132 L.Ed.2d 828 (1995). Because there is no conflict here, we need not address the various rules of statutory construction that normally might be applied to resolve such a conflict. We turn, then, to Felsenberg's alternative statutory construction argument. Relying on (1) his asserted conflict between the two subsections, (2) McDonnell v. Comm'n on Medical Discipline, 301 Md. 426, 483 A.2d 76 (1984), and (3) the title to 1988 Md. Laws, ch. 109, he avers that § 14-404(b) should be read to include only those crimes involving moral turpitude that do not involve either the practice of medicine or conduct included within § 14-404(a). We find no merit to that argument. The first prong of his argument is easily answered. For the reasons noted, we see no conflict between the two subsections. As to the second, McDonnell has no relevance to this case. The sole issue raised there was whether an alleged attempt by Dr. McDonnell to intimidate two prospective witnesses scheduled to testify against him in a medical malpractice case constituted immoral conduct of a physician in his practice as a physician  (emphasis added), and we said that it did not. Dr. McDonnell was never convicted of a crime and he was not charged with having been so convicted; the only question was whether his admittedly improper conduct was committed in his practice as a physician. Felsenberg's title argument is based on the fact that the title to 1988 Md. Laws, ch. 109, describes the provision included as § 14-404(b) as requiring the Board to suspend or revoke a license if the licensee is convicted or pleads guilty or nolo contendere to certain crimes of moral turpitude. (Emphasis added.) He points to the word certain as a word of limitation and draws from that a legislative intent to restrict § 14-404(b) to those crimes of moral turpitude not involving the practice of medicine and not otherwise covered under § 14-404(a). The word certain is commonly used in the titles to bills, usually to make the title sufficiently descriptive to assure compliance with Article III, § 29 of the Maryland Constitution. If the actual statutory language is ambiguous or susceptible to being construed in a limited way, the use of certain in the title may be taken into account, along with other things, in divining the legislative intent. It does not, however, of itself, serve to limit statutory language that is otherwise not so limited. The language of § 14-404(b), as enacted by the 1988 bill, is not limited; nor does the legislative history of that bill, recited above, suggest any legislative intent that it be limited.