Shicor v. Bd. of Speech Language Pathology & Audiology
Shicor v. Bd. of Speech Language Pathology & Audiology
Opinion of the Court
*370Licensee, a long time practitioner in the field of speech-language pathology, seeks judicial review of a final order of the Board of Speech Language Pathology and Audiology (the board) revoking her license to practice as a speech-language pathologist.
We take the following undisputed historical facts from the board's order. See Coffey v. Board of Geologist Examiners ,
In 2010, the board received a complaint alleging that licensee "exceeded the SLP scope of practice, used a method of therapy that is not professionally recognized, and billed for services that were actually provided by an unlicensed member of [her] family." Sandy Leybold, who was the board's executive director and whose duties included, among other things, conducting and overseeing board investigations, commenced an investigation into the allegations raised in the complaint. As part of that investigation, Leybold interviewed licensee. The investigation also included a review of licensee's client records and consultation with experts. During a telephone interview with Leybold, licensee "acknowledged that she uses iLS with nearly 100 percent of her clients and that [the American Speech-Language Hearing Association (ASHA) ] considered iLS to be experimental."
Late in 2011, while the investigation into the first complaint was ongoing, the board received a second complaint regarding licensee. That complaint alleged that licensee
"violated the speech-language pathology scope of practice, made professional judgments not based on professional best practices, advertised her services deceptively on the internet, used diagnostic treatment methodologies that may be ineffective or harmful, and was not ethical in selling devices to consumers that deliver those methodologies."
The board combined the complaints into a single investigation.
Licensee was a contracted provider with Regence Blue Cross/Blue Shield (Regence). The contract with Regence provided that Regence would pay licensee for "covered *372services," which included medically necessary speech therapy. The contract excluded from coverage services or procedures that were considered "investigational."
In 2011, Regence began an audit of services for which it had paid licensee. Based on records that Regence received from licensee, Regence's investigator determined that iLS was the primary service that licensee had provided to the clients whose records were part of the audit. The investigator also determined that licensee's treatment methods fell outside of Regence's policy on speech therapy because it considered iLS to be experimental. In her billing to Regence for the clients at issue, however, licensee had listed only "diagnosis code 92506 (speech therapy evaluation) or 92507 (speech therapy)." Regence informed licensee that, on review of her records, it had determined that the methods of treatment she employed were not traditional speech therapy and were, instead, "investigative and experimental" and therefore excluded from coverage. After the audit *641(including the internal appeal process) was complete, licensee terminated her Regence contract.
In 2012, the board issued a notice of proposed license revocation. Licensee requested a contested case hearing and the hearing was held before an administrative law judge (ALJ) in 2014.
*373The board issued an amended proposed order that adopted all of the findings of fact set forth in the ALJ's proposed order. It also accepted eight of the conclusions of law from the ALJ's proposed order. However, it rejected part of the ALJ's ninth conclusion of law, which related to, among other things, whether licensee had misrepresented the services she rendered. It also rejected the ALJ's recommendation that licensee's license be suspended because it determined that the "appropriate sanction in this case is revocation of Licensee's SLP license." That amended proposed final order was signed by Leybold.
Licensee filed exceptions to the amended proposed final order. In November 2014, the board issued its final order. In the final order, the board explained that it had considered licensee's exceptions to the amended proposed order but that it did not find any of those exceptions persuasive. It further adopted the amended proposed order in its entirety. Accordingly, the board revoked licensee's SLP license and assessed the costs of the disciplinary proceedings. The final order was signed by the board chair, Price. As noted, licensee seeks judicial review of the board's order.
In her first assignment of error, licensee asserts that the board violated her constitutional due process rights by allowing its executive director, Leybold, "to act as the primary investigator, a fact witness at trial, and the final decision maker." Specifically, licensee points out that Leybold investigated this case, issued a notice of the board's intent to revoke licensee's license, acted as a witness at the hearing before the ALJ, and signed the amended proposed order, which licensee characterizes as acting as a "judge" in the case. In licensee's view, Leybold's role in those various aspects of this case was constitutionally impermissible.
We begin by observing that, as the board correctly points out, one premise at least partially underlying licensee's assignment of error is mistaken. That is, licensee's assertion that Leybold acted as a "final decision-maker" or a "judge" in this case is incorrect. Although Leybold signed the amended proposed order, she was not the final decision-maker in the case. The final order, signed by the board chair, was the action of the entire board. The board considered whether to *374adopt the amended proposed order and considered but found unpersuasive licensee's exceptions to that proposed order. In the final order, it was the board itself, through its chair, that adopted the amended proposed order and ordered the revocation of licensee's license. In other words, it was not Leybold but, instead, the board, through its chair, that acted as the final decision-maker or "judge" in the case.
Furthermore, to the extent that licensee asserts that it violated her due process rights for Leybold to take part in various *642aspects of the administrative case, we reject that contention. "Due process demands impartiality on the part of those who function in quasi-judicial capacities." Llewellyn v. Board of Chiropractic Examiners ,
Instead, to establish a due-process violation in this context, licensee must demonstrate actual bias on the part of the decision-maker. See Becklin v. Board of Examiners for Engineering ,
Here, licensee has failed to demonstrate actual bias on the part of the board.
We turn next to licensee's fifth assignment of error. In that assignment, licensee asserts that the board erred in determining "in its conclusion of law and opinion No. 9" that she misrepresented her services in this case "by applying a preponderance of the evidence standard instead of a clear and convincing evidence standard." (Boldface omitted.) She also asserts that the board modified the ALJ's finding of fact and, therefore, pursuant to ORS 183.650(4), we must review the record on that issue de novo.
Pursuant to ORS 183.650(3), an "agency conducting a contested case hearing may modify a finding of historical fact made by the administrative law judge assigned from the Office of Administrative Hearings only if the agency determines that there is clear and convincing evidence in the record that the finding was wrong." An ALJ "makes a finding of historical fact if the administrative law judge determines that an event did or did not occur in the past *376or that a circumstance or status did or did not exist *643either before the hearing or at the time of the hearing."
"[n]othwithstanding ORS 19.415(3), if a party seeks judicial review of an agency's modification of a finding of historical fact under subsection (3) of this section, the court shall make an independent finding of the fact in dispute by conducting a review de novo of the record viewed as a whole. If the court decides that the agency erred in modifying the finding of historical fact made by the administrative law judge, the court shall remand the matter to the agency for entry of an order consistent with the court's judgment."
By the terms of the statute, we engage in de novo review only where the agency has modified one of the ALJ's findings of historical fact, that is, the ALJ's determination that a particular event did or did not occur in the past. See WaterWatch of Oregon v. Water Resources Dept. ,
Here, licensee asserts that the board modified the ALJ's factual findings when it rejected, in part, the ALJ's proposed conclusions relating to the board's allegation that, by using the billing code for speech therapy in her billings to Regence, licensee had misrepresented to Regence the services she provided in violation of OAR 335-005-0015(11).
The board did not reject the ALJ's understanding of the historical facts described above. Instead, the board-like the ALJ-accepted that licensee had provided iLS in conjunction with other therapy, and-again like the ALJ-also determined that iLS was central to licensee's practice. The board's analysis departed from the ALJ's at the next step of the analysis, that is, determining the legal significance of those historical facts. The board concluded, in light of its findings, that licensee's billings to Regence did constitute the kind of "misrepresent[ation]" that OAR 335-005-0015(11) prohibits because it falsely suggested that the entirety of licensee's services consisted of covered speech therapy. That conclusion-that licensee's conduct in this case violated OAR 335-005-0015(11) -was a legal issue. See Talbott v. Teacher Standards and Practices Comm. ,
*644Licensee next asserts that, even if the board did not change a historical finding of fact, the wrong evidentiary standard was applied in this case. Specifically, she asserts that, under Bernard v. Bd. of Dental Examiners ,
In Bernard , a dental license revocation case, we stated that "fraud or misrepresentation is never presumed and that even in a civil action the burden is on the person claiming it to establish its existence by clear, satisfactory and convincing evidence."
Affirmed.
Throughout this opinion, we refer to Janel Shicor, who is petitioner on review, as "licensee."
Licensee's sixth assignment is based on the arguments raised in her other assignments of error. Petitioner asks that the case be remanded to the board "for further review taking into consideration the Court's rulings." Because, as explained, we reject licensee's first through fifth assignments of error, we also reject her sixth assignment without additional written discussion.
In her reply brief, petitioner asserts that she challenged certain of the board's findings. The historical findings of fact set forth herein are undisputed.
As the board noted in its order, licensee later changed her view on this issue and took the position that iLS was not experimental.
As a result of Regence's determination that the services for which petitioner had billed were not covered, despite having been billed as speech therapy or speech therapy evaluation, petitioner was informed that she needed to reimburse Regence $27,807.26 for the cases involved in the audit. The board found that petitioner had not paid that sum back to Regence at the time of the hearing before the administrative law judge in this case.
Before the hearing, the ALJ had granted, in part, and denied, in part, the board's motion for summary determination. Specifically, the ALJ granted summary determination in favor of the board on the allegation that petitioner failed to comply with the board's record-keeping requirements. That ruling is not at issue on judicial review.
We observe that licensee bases her argument largely on a statement that she contends the board's attorney made during a settlement meeting. Among other problems with her argument, as in Llewellyn , licensee "fail[s] to recognize that the decision-maker in a license revocation proceeding is the Board , not the Board's lawyer ."
Pursuant to OAR 335-005-0015(11), SLPs
"shall not charge for services not rendered, nor shall they misrepresent in any fashion, services rendered or products dispensed."
Licensee, in her reply brief argues that, even "if the preponderance of the evidence standard applied (which it does not)," there is insufficient evidence to support the board's conclusion that she misrepresented her services to Regence in violation of OAR 335-005-0015(11). We reject that contention without discussion.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.