Board dismisses charges against Dr. Harold Pelton after hearing; non-adjudicated plea and OIG exclusion noted

The State Board of Medical Licensure dismissed disciplinary charges Wednesday against ophthalmologist Dr. Harold Lee Pelton following a contested hearing. The decision came after the board reviewed records that included a state indictment that was ultimately resolved through a plea package and a non-adjudication order.

Why it matters: The case raises the intersection of criminal plea practices, state disciplinary authority and federal administrative exclusion. Pelton’s advocates told the board the matters that led to administrative action were largely billing disputes that had been the subject of audits and settlements and that the non-adjudication in state court, as well as administrative decisions at the federal level, warranted no additional state licensing sanction.

What the board heard: Counsel for the prosecution described a multi-stage history: a Medicare/ZPIC audit that identified disputed billings, a subsequent federal review that resulted in repayment and a later state Medicaid 16-count indictment. Pelton and his attorney, Tom Kirkland, told the board that Pelton negotiated a resolution with the attorney general’s office that included a single guilty plea that the circuit court then non-adjudicated and converted into three years of unsupervised probation with conditions (court costs and a small fine). Pelton testified the conduct underlying the state action arose from coding and billing disputes — he described changes in Medicare carrier policy during the period at issue and said payments were repaid to resolve the related audits.

The transcript includes reference to an administrative law judge’s decision on a federal OIG exclusion appeal that described the underlying facts as closer to a billing error than criminal fraud but concluded that the OIG’s authority nonetheless supported exclusion; Pelton’s counsel argued that the ALJ’s opinion and a pending waiver request to OIG justified leniency by the board. Pelton testified about long-term service in an underserved area, high patient volume, reliance on older coding guidance and the disruption the proceedings caused for his family.

Board action: After retiring to executive session to consider the evidence and the record, the board announced it would dismiss the charges against Pelton. The board directed staff to document the dismissal; no additional public conditions were announced.

Context and next steps: Pelton remains on the OIG exclusion list unless and until a federal waiver or rescission is granted; the board’s dismissal means the state licensing division will not impose a state disciplinary restriction based on the matters it reviewed at this hearing. Pelton’s attorneys indicated they are pursuing administrative and federal remedies regarding the OIG exclusion and any remaining collateral effects.

Sources: Board exhibits included the state indictment and plea transcripts, a non-adjudication order from circuit court, federal audit materials and the administrative law judge opinion on OIG exclusion proceedings.