Telehealth Online Clinics Subscription Apps Compliance California

Published: December 5, 2025 • Demand Letters, Medical

California Telehealth, Online Clinics & Subscription Apps – Compliance Failures & Demand Letters | Attorney Sergei Tokmakov

Contents

California Telehealth, Online Clinics & Subscription Apps

Compliance Failures, Unlicensed Practice, Knox-Keene Violations & Demand Letters

Attorney Sergei Tokmakov – Telehealth Regulatory Enforcement & Consumer Protection

California’s telehealth explosion has created a minefield of regulatory violations. Out-of-state providers practicing without California licenses. Subscription apps operating as unlicensed health plans under Knox-Keene. Platforms misrepresenting “board-certified physician” involvement when patients see unlicensed providers or AI chatbots. Informed consent violations under B&P § 2290.5. Whether you’re a patient demanding refunds for unlicensed care, a licensed physician whose name is being misused, or a clinic partner facing compliance liability—I help you assert your rights through strategic demand letters backed by California telehealth law.

Overview: The Telehealth Compliance Crisis in California

California’s telehealth industry has grown exponentially—online clinics, subscription apps, out-of-state provider networks. But growth has outpaced compliance. Many platforms operate in a regulatory gray zone, exploiting ambiguities in licensing, informed consent, and health plan regulation.

The Core Compliance Failures

1. Unlicensed Out-of-State Providers – B&P § 2052 requires California licensure to treat California patients, even via telehealth. Many platforms use out-of-state physicians without California licenses, constituting unlicensed practice of medicine.

2. Informed Consent Violations – B&P § 2290.5 mandates specific informed consent for telehealth encounters (provider identity, qualifications, limitations of telehealth modality). Most subscription apps provide generic checkboxes, not compliant disclosures.

3. Knox-Keene Unlicensed Health Plans – Monthly subscription models offering “unlimited visits” or bundled services may constitute health plans requiring DMHC licensure under Health & Safety Code § 1340 et seq.

4. Misrepresentation of Physician Involvement – Platforms advertising “board-certified physicians” but delivering care via nurse practitioners, health coaches, or AI chatbots violate UCL (B&P § 17200) and False Advertising Law (B&P § 17500).

5. Corporate Practice of Medicine (CPOM) – Non-physician entities (tech companies, private equity) controlling medical decision-making violate B&P § 2400. Many telehealth platforms lack compliant Professional Corporation structures.

Who Has Standing to Sue?

Patients can demand refunds for services rendered by unlicensed providers, void contracts under illegality doctrine, and pursue UCL/CLRA claims for misrepresentation. Licensed physicians whose names/credentials are misused can pursue defamation, right of publicity violations, and Medical Board complaints. Clinic partners (landlords, equipment vendors) can rescind agreements with unlicensed operators and assert priority liens.

Strategic Value of Pre-Litigation Demand Letters

Telehealth companies fear regulatory scrutiny. A well-drafted demand letter citing Medical Board jurisdiction, DMHC enforcement authority, and FTC consumer protection creates powerful settlement pressure. Most platforms lack compliant legal structures and prefer confidential settlements to agency investigations.

⚠ Extortion and Unauthorized Practice Warnings

Permitted: “I am prepared to submit a detailed complaint to the Medical Board of California documenting [provider name]’s unlicensed practice under B&P § 2052, unless this matter is resolved within 10 days.”

Prohibited: “Pay $50,000 or I will destroy your business by reporting you to every agency.” (Extortion under California Penal Code § 518.)

Licensed attorneys may draft demand letters and negotiate settlements. Non-attorneys providing legal advice or drafting demand letters engage in unauthorized practice of law (B&P § 6125).

California Telehealth Legal Framework

California has developed the nation’s most comprehensive telehealth regulatory framework. Understanding these statutes is essential for asserting patient rights and physician liability.

Business & Professions Code § 2290.5 – Telehealth Statute

Enacted to ensure telehealth meets the same standard of care as in-person medicine, B&P § 2290.5 requires:

Informed Consent – Before initiating telehealth encounter, provider must obtain informed consent including: (1) provider’s identity and qualifications, (2) limitations of telehealth modality, (3) potential risks, (4) patient’s right to withhold consent
Good Faith Prior Examination – For prescribing, physician must establish “good faith prior examination” (may be telehealth exam if appropriate for condition)
Medical Records – Telehealth encounters must be documented in patient’s medical record with same standards as in-person visits
Standard of Care – Telehealth services must meet same standard of care as in-person services

Violations create Medical Board jurisdiction and potential professional discipline, but also serve as UCL predicate offenses for patient civil claims.

Business & Professions Code § 2052 – California Licensure Requirement

Any person practicing medicine in California must hold a valid California medical license. This applies to:

Out-of-state physicians treating California residents via telehealth
Physicians with licenses in other states but not California
Foreign-trained physicians with credentials abroad

Exception: Interstate Medical Licensure Compact (IMLC) provides expedited licensure for qualified physicians, but still requires obtaining California license before treating California patients.

Penalty: Unlicensed practice is a crime (B&P § 2052 – misdemeanor) and creates absolute liability. Contracts for unlicensed medical services are void and unenforceable. Patients may recover all fees paid under restitution theory.

Knox-Keene Health Care Service Plan Act (Health & Safety Code § 1340 et seq.)

Subscription telehealth models frequently trigger Knox-Keene licensure requirements. A “health care service plan” is defined as any entity that arranges for provision of health care services to subscribers in exchange for prepaid or periodic charges (HSC § 1345(f)).

Factors indicating Knox-Keene coverage:

Factor	Compliant Model	Knox-Keene Trigger
Payment Structure	Fee-for-service per visit	Monthly subscription with “unlimited visits”
Provider Network	Patient chooses any licensed provider	Platform directs to network of employed/contracted providers
Risk Bearer	Patient pays directly for each service	Platform assumes financial risk (fixed fee regardless of utilization)
Service Bundling	Unbundled services (visit, lab, prescription separate)	Bundled services (subscription includes visits, labs, medications)

Operating as unlicensed health plan: DMHC enforcement authority includes cease-and-desist orders, civil penalties up to $500,000 (HSC § 1386), and criminal prosecution. Subscriber agreements are void. Patients may demand full refunds of all subscription fees paid.

Unfair Competition Law (B&P § 17200) & False Advertising Law (B&P § 17500)

Telehealth platforms routinely make false or misleading claims:

“Board-certified physicians” when patients see nurse practitioners or unlicensed coaches
“Same quality as in-person care” when using AI chatbots or questionnaire-based prescribing
“Licensed in all 50 states” when providers lack California licenses
“FDA-approved treatments” for compounded medications or off-label prescribing

UCL/FAL remedies: Restitution (refund of all fees paid), injunctive relief (cease false advertising), civil penalties. Private right of action for consumers under UCL and CLRA (Consumers Legal Remedies Act, Civil Code § 1750 et seq.).

California Telehealth Compliance Checklist

All providers hold valid, active California medical licenses (verify at mbc.ca.gov)
Informed consent obtained before each encounter per B&P § 2290.5
Provider identity, qualifications, and limitations disclosed to patient
Good faith prior examination established before prescribing
Medical records maintained with same standards as in-person visits
Subscription model analyzed for Knox-Keene applicability
If Knox-Keene applies, DMHC full-service health plan license obtained
Marketing materials accurately represent provider credentials (MD vs. NP vs. RN)
No misrepresentation of treatment effectiveness, FDA approval status, or safety
HIPAA-compliant telehealth platform (BAA with vendor, encrypted video)
Corporate structure complies with CPOM (physician-owned PC if applicable)

Common Telehealth Compliance Violations

Based on my practice representing patients, licensed physicians, and clinic partners, here are the most frequent telehealth violations in California:

Violation #1: Out-of-State Providers Without California Licenses

Fact Pattern: Subscription telehealth platform advertises “nationwide network of physicians.” Patient in Los Angeles subscribes for $99/month. First visit is with physician licensed in Florida and Texas, but not California. Physician prescribes medication without ever obtaining California license.

Legal Violation:

Unlicensed practice of medicine (B&P § 2052)
Void contract (illegality doctrine – cannot enforce agreement for illegal services)
UCL violation (unfair business practice)
Medical Board jurisdiction over platform operators for aiding/abetting unlicensed practice

Patient Remedies: Demand full refund of all subscription fees paid. Report to Medical Board. File UCL action for restitution and injunctive relief. Any adverse outcomes from unlicensed care support medical malpractice claims (no standard of care met when care is per se illegal).

Violation #2: Informed Consent Checkbox Theater

Fact Pattern: Telehealth app’s signup flow includes generic checkbox: “I consent to receive telehealth services.” No disclosure of specific provider identity, qualifications, or limitations of the particular modality (asynchronous messaging vs. video vs. AI chatbot). Patient discovers after adverse outcome that “physician consult” was actually nurse practitioner reviewing questionnaire responses.

Legal Violation:

B&P § 2290.5 informed consent failure (must disclose provider identity and qualifications)
Misrepresentation (promised “physician” but delivered NP without disclosure)
Standard of care violation (informed consent is element of standard of care)

Patient Remedies: Void consent (uninformed consent is no consent). Medical malpractice claim if adverse outcome. UCL restitution claim for fees paid under false pretenses.

Violation #3: Knox-Keene Unlicensed Health Plan Operation

Fact Pattern: “Primary Care Membership” app charges $199/month for: (1) unlimited video visits with app’s employed physicians, (2) discounted lab testing at contracted facilities, (3) prescription delivery service, (4) 24/7 nurse hotline. App assumes financial risk (same $199 whether member uses 0 or 20 visits). App operates without DMHC license.

Legal Violation:

Operating as unlicensed health care service plan (HSC § 1340 et seq.)
Arranging for health care services to subscribers in exchange for prepaid periodic charges
Assuming financial risk (characteristic of health plans vs. fee-for-service)
DMHC enforcement jurisdiction

Patient Remedies: Subscriber agreement is void (cannot contract for illegal health plan operation). Demand refund of all subscription fees paid. Report to DMHC for cease-and-desist order. Priority over app’s other creditors for restitution.

Violation #4: “Board-Certified Physician” Bait-and-Switch

Fact Pattern: Weight loss telehealth company’s website and Instagram ads prominently feature “Board-Certified Physicians” and display photos of doctors in white coats with stethoscopes. Patient subscribes expecting physician oversight. Actual care is delivered by “health coaches” (no medical license) who use proprietary algorithm to recommend supplements. “Physician review” is rubber-stamp approval of AI-generated recommendations, 5 seconds per patient.

Legal Violation:

False advertising (B&P § 17500) – representing physician involvement when care is delivered by unlicensed personnel
UCL (B&P § 17200) – unfair and deceptive business practice
CLRA (Civil Code § 1750) – misrepresenting services’ characteristics
Unlicensed practice of medicine by health coaches
CPOM violation (non-physician entity controlling medical decisions)

Patient Remedies: Actual damages plus restitution of all fees paid. Punitive damages if intentional misrepresentation. Injunctive relief (stop false advertising). CLRA allows recovery of attorney fees.

Violation #5: Prescription Mills – No Good Faith Examination

Fact Pattern: Online “men’s health” clinic offers ED medication, testosterone, hair loss treatment. “Consultation” is 5-question online form (age, symptoms, allergies, medications, consent checkbox). No video exam, no patient history review, no follow-up. Prescription automatically generated and shipped within 24 hours. Physician rubber-stamps 100+ prescriptions per day without individualized assessment.

Legal Violation:

No good faith prior examination (B&P § 2290.5(e))
Gross negligence / medical malpractice (prescribing without adequate history, exam, diagnosis)
DEA violations if controlled substances (21 CFR § 1306.04 requires legitimate medical purpose)
Medical Board jurisdiction – unprofessional conduct, gross negligence

Patient Remedies: Medical malpractice claim if adverse outcome (ED medications with undiagnosed cardiac contraindications, testosterone without baseline labs causing thrombosis). Report to Medical Board. Report to DEA if controlled substances. Void contract / refund demand if no legitimate medical service provided.

Violation #6: Telehealth Franchises & CPOM Violations

Fact Pattern: Private equity firm launches telehealth “franchise” model. Non-physician investors buy franchise rights to operate branded telehealth clinics. Franchisor (non-physician entity) controls: (1) marketing and patient acquisition, (2) pricing and fee schedules, (3) treatment protocols and prescribing guidelines, (4) physician hiring and termination, (5) quality metrics and patient volume quotas. Physicians are W-2 employees of franchise entity (LLC owned by investors, not physicians).

Legal Violation:

Corporate Practice of Medicine (B&P § 2400) – non-physician entity controlling medical decisions
Fee-splitting (B&P § 650) – non-physician investors receiving profits from physician services
Physician employment by non-physician entity (violates CPOM)
Medical Board jurisdiction over investors and franchisor for aiding/abetting CPOM violations

Physician Remedies: Rescind employment agreement (void as against public policy). Recover unpaid wages/benefits. Blow whistle to Medical Board. Assert claims against investors and franchisor for CPOM violations.

⚠ “Telehealth” Is Not a Regulatory Exemption

Many telehealth operators mistakenly believe that “online” or “digital health” services are exempt from traditional medical licensing, informed consent, and corporate practice restrictions. They are not. California law explicitly states that telehealth services must meet the same standard of care as in-person services (B&P § 2290.5(a)(3)). The modality (video, phone, asynchronous messaging) does not eliminate licensing requirements, informed consent obligations, or CPOM prohibitions.

If your telehealth business model would be illegal in a brick-and-mortar clinic, it is equally illegal online.

Sample Demand Letters – Telehealth Compliance Violations

Below are sample demand letters for common telehealth scenarios. These are templates for educational purposes and must be customized to your specific facts, jurisdiction, and legal claims. I draft demand letters for clients as part of comprehensive representation.

SAMPLE PATIENT DEMAND LETTER – UNLICENSED OUT-OF-STATE PROVIDER REFUND [Date] [Telehealth Company Name] [Address] [City, State ZIP] Re: Demand for Full Refund – Unlicensed Practice of Medicine Patient: [Patient Name] Account No.: [Account Number] Dear [Company Representative]: I represent [Patient Name] (“Patient”), who subscribed to your telehealth services from [date] through [date], paying total fees of $[amount]. FACTUAL BACKGROUND Patient enrolled in your subscription telehealth service on [date], paying $[amount]/month for advertised “physician consultations.” Your marketing materials represented that patients would receive care from “board-certified physicians” and “licensed medical providers.” On [date], Patient had initial consultation regarding [condition]. The provider was [Provider Name], who identified as a physician. Patient relied on your representations and [Provider Name]’s apparent authority to prescribe [medication]. Subsequent investigation revealed that [Provider Name] holds medical licenses in [other states] but has never held a valid California medical license. Verification via Medical Board of California public database (mbc.ca.gov) confirms [Provider Name] is not licensed to practice medicine in California. LEGAL VIOLATIONS 1. Unlicensed Practice of Medicine (B&P § 2052) – [Provider Name]’s provision of medical services to California resident constitutes unlicensed practice, a criminal misdemeanor. 2. Void Contract – Agreements for illegal services (unlicensed medical practice) are void and unenforceable under California illegality doctrine. Patient owes nothing for illegal services. 3. Unfair Competition (B&P § 17200) – Operating telehealth business using unlicensed providers is unfair business practice entitling Patient to restitution. 4. False Advertising (B&P § 17500) – Representing “licensed medical providers” when providers lack California licenses is false advertising. DEMAND Patient demands immediate refund of all fees paid: $[total amount] (calculated as [number] months × $[monthly fee]). Payment must be made within 10 business days via check payable to [Patient Name] at [address], or electronic transfer to [payment details]. REGULATORY REPORTING If this matter is not resolved within 10 business days, Patient will submit formal complaints to: • Medical Board of California documenting [Provider Name]’s unlicensed practice under B&P § 2052 and [Company]’s aiding and abetting unlicensed practice • California Attorney General’s Office – Healthcare Rights & Access Section for UCL/FAL violations • Federal Trade Commission for deceptive telehealth marketing practices Additionally, Patient reserves all rights to file civil action for restitution under UCL, CLRA damages, and any harm arising from unlicensed medical care. NO WAIVER Patient specifically does not waive any claims arising from unlicensed medical care, including but not limited to medical malpractice (if applicable), emotional distress, and statutory damages under consumer protection statutes. I await your prompt response. Sincerely, [Attorney Name] Attorney for [Patient Name] [Contact Information]

SAMPLE PHYSICIAN DEMAND LETTER – CREDENTIAL MISUSE / DEFAMATION [Date] [Telehealth Platform Name] [Address] [City, State ZIP] Re: Cease and Desist – Unauthorized Use of Name and Medical Credentials Physician: [Physician Name], M.D. California Medical License: [License Number] Dear [Platform Representative]: I represent [Physician Name], M.D. (“Dr. [Last Name]”), a licensed California physician, regarding your unauthorized use of Dr. [Last Name]’s name, medical credentials, and professional reputation in connection with your telehealth platform. UNAUTHORIZED USE OF IDENTITY Your website and marketing materials prominently display Dr. [Last Name]’s name, photograph, medical degree, and board certification as an endorsement of your services and to represent that Dr. [Last Name] provides medical supervision or consultation to your patients. Dr. [Last Name] has never contracted with your company, never authorized use of [his/her] name or credentials, and does not provide any services to your patients. Your platform uses Dr. [Last Name]’s identity to create false impression of physician oversight when actual patient care is delivered by [unlicensed health coaches / out-of-state providers without CA licenses / automated algorithms]. LEGAL VIOLATIONS 1. Misappropriation of Name and Likeness (Civil Code § 3344) – Commercial use of Dr. [Last Name]’s name, photograph, and professional identity without consent. Statutory damages of greater of actual damages or $750, plus punitive damages. 2. Defamation / False Light – Falsely representing Dr. [Last Name]’s association with unlicensed or substandard care injures professional reputation. 3. Unfair Competition (B&P § 17200) – Using physician credentials without authorization to sell services is unfair business practice. 4. Medical Board Violations – Misrepresenting physician involvement may violate B&P provisions regarding false advertising of medical services. DEMAND Dr. [Last Name] demands immediate cessation of all unauthorized use: 1. Remove all references to Dr. [Last Name]’s name, photograph, credentials, and professional affiliations from your website, mobile app, marketing materials, and social media within 48 hours. 2. Issue written confirmation that all uses have been removed and will not resume. 3. Compensate Dr. [Last Name] for past unauthorized commercial use: $[amount] (calculated as fair market value of physician endorsement × duration of use). CONSEQUENCES OF NON-COMPLIANCE If full compliance is not achieved within 48 hours, Dr. [Last Name] will file civil action seeking: • Statutory damages under Civil Code § 3344 • Actual damages for reputational harm and lost professional opportunities • Punitive damages for willful and malicious misappropriation • Injunctive relief (court order to remove all references) • Attorney fees and costs Additionally, Dr. [Last Name] will report your company to the Medical Board of California for fraudulent representation of physician involvement and to the Federal Trade Commission for deceptive advertising. PRESERVATION OF EVIDENCE Dr. [Last Name] has preserved screenshots, archived web pages, and marketing materials documenting unauthorized use. Do not destroy or alter any evidence related to this matter. Confirm compliance within 48 hours. Sincerely, [Attorney Name] Attorney for [Physician Name], M.D. [Contact Information]

SAMPLE DMHC COMPLAINT – UNLICENSED HEALTH PLAN OPERATION [Date] California Department of Managed Health Care Office of Enforcement 980 9th Street, Suite 500 Sacramento, CA 95814 Re: Complaint Against [Telehealth Company Name] for Operating as Unlicensed Health Care Service Plan Dear DMHC Enforcement Staff: I submit this complaint on behalf of [Your Name] (“Complainant”), a California resident and subscriber to [Telehealth Company]’s subscription telehealth service, which operates as an unlicensed health care service plan in violation of the Knox-Keene Health Care Service Plan Act (Health & Safety Code § 1340 et seq.). RESPONDENT INFORMATION Company Name: [Telehealth Company Name] Business Address: [Address] Website: [URL] Approximate California Subscribers: [Estimate based on public information] UNLICENSED HEALTH PLAN OPERATION [Company] operates a subscription telehealth service charging $[amount]/month for: • Unlimited video consultations with network of employed/contracted physicians • Discounted laboratory testing at contracted facilities • Prescription fulfillment and delivery service • 24/7 nurse hotline access • [Other bundled services] This business model meets the statutory definition of “health care service plan” under HSC § 1345(f): 1. Arranges for Provision of Health Care Services – Company maintains network of employed/contracted physicians and contracts with labs, pharmacies, and other providers to deliver services to subscribers. 2. Prepaid or Periodic Charges – Subscribers pay fixed monthly fee ($[amount]) regardless of utilization (not fee-for-service). 3. Assumption of Financial Risk – Company assumes risk of subscriber utilization. Whether subscriber uses 0 visits or 20 visits, fee remains $[amount]. This risk-bearing is characteristic of health plans, not fee-for-service medical practices. 4. California Subscribers – Company actively markets to California residents and has substantial California subscriber base. NO DMHC LICENSE DMHC public database search confirms [Company] does not hold health care service plan license. Company is not registered as licensed health plan or restricted Knox-Keene plan. HARM TO SUBSCRIBERS Unlicensed health plan operation denies California subscribers critical Knox-Keene protections: • No DMHC financial solvency oversight (risk of company insolvency leaving subscribers without access to prepaid care) • No grievance and independent medical review procedures • No continuity of care protections • No DMHC enforcement of quality standards • Subscriber agreements are void (cannot enforce contracts for illegal health plan operation) Complainant paid total of $[amount] over [timeframe] for services under void contract. REQUESTED ENFORCEMENT ACTION Complainant requests that DMHC: 1. Investigate [Company]’s business model and determine whether it constitutes health care service plan requiring licensure 2. Issue cease and desist order if [Company] is operating as unlicensed plan (HSC § 1386) 3. Impose civil penalties (up to $500,000 per HSC § 1386(b)) 4. Order restitution to all California subscribers of fees paid under void contracts 5. Refer for criminal prosecution if appropriate (HSC § 1386(e) – knowing operation of unlicensed plan is misdemeanor) SUPPORTING DOCUMENTATION Enclosed: • Subscriber agreement • Payment records (bank statements showing monthly charges) • Marketing materials from website and social media • Screenshots of service offerings and fee structure I am available to provide additional information and testimony as needed. Respectfully submitted, [Your Name] [Attorney if represented] [Contact Information]

✓ Demand Letter Best Practices

Specificity: Cite exact statute sections (B&P § 2052, not “licensing violations”). Quote specific misrepresentations from company’s website/marketing materials.

Documentation: Attach provider license verification from mbc.ca.gov, payment records, subscription agreement, marketing screenshots with date/time stamps.

Realistic Damages: Calculate refund demand as sum of all payments made (objectively verifiable). Avoid speculative damages in initial demand.

Regulatory Leverage Without Extortion: Stating intent to file legitimate agency complaints is protected speech. Demanding money in exchange for not filing crosses into extortion. Proper phrasing: “If not resolved within 10 days, I will file complaints with Medical Board and DMHC.” Improper: “Pay $X to avoid regulatory nightmare.”

Preservation Notice: Demand preservation of evidence (patient records, prescribing records, provider credentials, subscription data). Creates litigation hold and potential spoliation claims if destroyed.

Regulatory Leverage in Telehealth Disputes

Telehealth platforms are exceptionally vulnerable to regulatory enforcement. Unlike traditional medical practices with decades of established compliance, many telehealth companies are venture-backed startups that prioritized rapid growth over legal compliance. Strategic demand letters highlighting regulatory violations create powerful settlement pressure.

Medical Board of California – Unlicensed Practice Enforcement

Jurisdiction: Medical Board has authority over (1) physicians practicing in California, (2) individuals practicing medicine without a license, and (3) entities that aid and abet unlicensed practice.

Enforcement Actions:

Investigation of unlicensed practice complaints (B&P § 2052)
Citation and fine (up to $5,000 per violation)
Cease and desist orders
Referral to local DA for criminal prosecution (misdemeanor, up to 6 months jail + fine)
Discipline of licensed physicians who aid/abet unlicensed practice (e.g., rubber-stamping other providers’ decisions)

How to File Complaint: Online at mbc.ca.gov or mail to Medical Board of California, Attn: Enforcement Division. Include: provider name, dates of service, description of unlicensed practice, copies of prescriptions/medical records, your contact information.

Strategic Value: Medical Board complaints are public record (after investigation). Telehealth platforms fear publicity of unlicensed practice investigations. Use in demand letter: “If not resolved within 10 days, I will file formal complaint with Medical Board documenting [specific unlicensed providers and dates of service].”

Department of Managed Health Care (DMHC) – Unlicensed Health Plan Enforcement

Jurisdiction: DMHC regulates health care service plans (Knox-Keene Act). If subscription telehealth model constitutes health plan, DMHC has enforcement authority.

Enforcement Actions:

Investigation of unlicensed plan operation
Cease and desist orders (HSC § 1386)
Civil penalties up to $500,000
Restitution orders (refund subscribers)
Referral for criminal prosecution (knowing operation of unlicensed plan is misdemeanor)

How to File Complaint: DMHC Help Center at 888-HMO-2219 or online complaint form at dmhc.ca.gov. Explain subscription fee structure, bundled services, risk-bearing, and lack of DMHC license.

Strategic Value: DMHC enforcement is aggressive and well-funded. Unlicensed plan operation exposes company to catastrophic liability (all subscriber agreements void, potential $500K penalty). Credible DMHC complaint threat creates extreme settlement pressure.

California Attorney General – Consumer Protection Enforcement

Jurisdiction: AG enforces UCL (B&P § 17200) and FAL (B&P § 17500). Health care fraud is priority enforcement area.

Enforcement Actions:

Investigation of false advertising and unfair business practices
Civil enforcement action seeking injunction, restitution, civil penalties
Criminal prosecution for egregious fraud

How to File Complaint: AG Public Inquiry Unit at 800-952-5225 or online at oag.ca.gov/contact/consumer-complaint. Focus on false advertising (misrepresenting provider credentials, licensing status, treatment effectiveness).

Federal Trade Commission (FTC) – Deceptive Telehealth Marketing

Jurisdiction: FTC Act § 5 prohibits unfair or deceptive acts or practices in commerce. FTC has prioritized telehealth enforcement during COVID-19 expansion.

Recent FTC Actions:

2023: FTC settled with telehealth company for $1.5M over deceptive “board-certified physician” claims when care delivered by unlicensed personnel
2022: FTC action against online prescribing platform for failing to disclose physician licensing deficiencies

How to File Complaint: ReportFraud.ftc.gov. Describe false advertising, attach marketing materials, explain consumer harm.

Strategic Value: FTC enforcement is public and creates national publicity. Telehealth companies with venture funding fear FTC actions (impacts future fundraising, acquisition prospects). Credible FTC complaint threat strengthens settlement position.

DEA – Controlled Substance Prescribing Violations

Jurisdiction: If telehealth platform prescribes controlled substances (Adderall, testosterone, benzodiazepines, opioids) without compliant examination, DEA has criminal enforcement authority.

Violations: 21 CFR § 1306.04 requires prescriptions be issued for “legitimate medical purpose” by practitioner “acting in the usual course of professional practice.” Rubber-stamp prescribing via online questionnaires violates these requirements.

How to Report: DEA Diversion Control Division at 800-882-9539 or dea.gov/report-crime.

Strategic Value: DEA investigations are criminal. Physicians and platform operators face potential federal prosecution, DEA license revocation, and exclusion from Medicare/Medicaid. Extremely powerful leverage in demand letters for platforms prescribing controlled substances.

⚠ Ethical Boundaries: Permitted vs. Prohibited Regulatory Threats

Permitted:

“If this matter is not resolved within 10 days, I will submit detailed complaint to Medical Board of California documenting the unlicensed practice of [Provider Name] under B&P § 2052.”
“I am prepared to report this Knox-Keene violation to DMHC unless we reach resolution.”
“Failure to provide refund will result in complaints to Medical Board, DMHC, Attorney General, and FTC.”

Prohibited (Extortion under Penal Code § 518):

“Pay $50,000 within 3 days or I will destroy your business by reporting you to every agency and posting on social media.”
“Settlement requires payment of $X in exchange for agreement not to file regulatory complaints.” (Conditioning settlement on non-reporting may violate public policy.)
“I have connections at the Medical Board and can make this go away for the right price.”

Key Distinction: You may state intent to file legitimate complaints if dispute is not resolved. You may NOT demand payment in exchange for agreement not to file complaints (treating regulatory process as commodity for sale).

Private Civil Actions – UCL, CLRA, Medical Malpractice

Beyond regulatory complaints, patients and physicians have private civil remedies:

Unfair Competition Law (B&P § 17200):

Restitution (refund of all fees paid)
Injunctive relief (court order to stop unlicensed practice or false advertising)
Standing: any person who suffered injury in fact and lost money or property (broad standing for consumers)
No punitive damages or attorney fees under UCL alone (but can combine with other claims)

Consumers Legal Remedies Act (CLRA – Civil Code § 1750 et seq.):

Actual damages (out-of-pocket losses)
Punitive damages (if knowing/willful misrepresentation)
Attorney fees to prevailing plaintiff
Requires pre-suit demand letter giving 30 days to correct (Civil Code § 1782)

Medical Malpractice:

If unlicensed practice or telehealth negligence caused patient harm (misdiagnosis, medication error, failure to diagnose), patient may assert medical malpractice
Unlicensed practice = per se negligence (no standard of care met when practice is illegal)
MICRA caps on non-economic damages ($250K, increased to $500K under AB 35 for post-2023 cases)

Attorney Services – Telehealth Compliance & Enforcement

I represent patients, licensed physicians, and healthcare businesses in California telehealth disputes. My practice focuses on strategic demand letters, regulatory complaints, and private civil actions to enforce compliance with California’s telehealth laws.

Patient Representation

I help patients who have been harmed by unlicensed telehealth providers, misleading subscription apps, or negligent online prescribing:

Refund Demands – Draft demand letters seeking full refund of fees paid to unlicensed providers or unlicensed health plans (void contracts)
Medical Board Complaints – Prepare detailed complaints documenting unlicensed practice, informed consent failures, and substandard care
DMHC Complaints – Analyze subscription telehealth business models for Knox-Keene violations and file enforcement complaints
UCL/CLRA Actions – File civil actions for restitution, injunctive relief, and damages based on false advertising and unfair business practices
Medical Malpractice – Evaluate telehealth negligence claims (misdiagnosis, medication errors, failure to diagnose) and pursue compensation for patient harm

Physician Representation

I represent licensed California physicians whose names, credentials, or professional reputations are being misused by telehealth platforms:

Cease and Desist Letters – Demand immediate removal of unauthorized use of physician name, photograph, credentials, and professional affiliations
Misappropriation Claims – Assert Civil Code § 3344 claims for commercial use of name/likeness without consent (statutory damages + punitive damages)
Defamation / False Light – Pursue claims against platforms that falsely associate physicians with substandard or unlicensed care
Medical Board Defense – Defend physicians who face Medical Board complaints arising from telehealth platform employment (CPOM violations, supervision failures)

Healthcare Business Consulting

I advise telehealth startups, medical practices, and digital health companies on California compliance:

Knox-Keene Analysis – Evaluate whether subscription telehealth model triggers health plan licensure requirements and structure compliant alternatives
Licensing Compliance – Ensure all providers hold valid California licenses before treating California patients (Interstate Medical Licensure Compact expedited licensure)
Informed Consent Protocols – Draft B&P § 2290.5-compliant informed consent forms and implement compliant workflows
CPOM-Compliant Structures – Design compliant corporate structures (physician-owned PCs, compliant MSAs) to avoid Corporate Practice of Medicine violations
Marketing Review – Review website, app, and advertising materials for UCL/FAL compliance (accurate provider credentials, no misrepresentation of treatment effectiveness)

Submit Your Telehealth Case for Review

I offer confidential case evaluations for California telehealth disputes. Whether you’re a patient seeking refund for unlicensed care, a physician whose credentials are being misused, or a healthcare business facing compliance issues—I can help you understand your rights and options.

Schedule a consultation below to discuss your case. I’ll analyze the specific facts, applicable California statutes (B&P § 2052, § 2290.5, Knox-Keene, UCL/FAL), and develop a strategic enforcement plan.

Fee Structure: Patient refund demands are handled on contingency (percentage of recovery, no upfront fees). Physician credential misuse cases are flat fee or hourly. Healthcare business consulting is hourly or project-based flat fee. Specific fee arrangements discussed during consultation.

Why Clients Choose My Practice

California Telehealth Expertise: I focus exclusively on California healthcare law. I understand the nuances of B&P § 2290.5, Knox-Keene applicability to subscription models, CPOM doctrine, and Medical Board enforcement procedures.

Strategic Regulatory Leverage: I know how to draft demand letters that create maximum settlement pressure by highlighting Medical Board, DMHC, AG, and FTC enforcement exposure—without crossing into extortion.

Realistic Expectations: I provide candid assessment of your case strength, likely outcomes, and cost-benefit analysis. I don’t overpromise results or encourage frivolous claims.

Efficient Resolution: Most telehealth disputes settle after well-crafted demand letter. I prioritize efficient resolution over protracted litigation when possible.

Litigation-Ready: When settlement is not possible, I am fully prepared to file and prosecute civil actions (UCL, CLRA, medical malpractice, misappropriation) through trial.

✓ Recent Results (Illustrative Examples – Not Guarantees)

Patient Refund – Unlicensed Provider: Negotiated full refund ($4,800 in subscription fees) for patient who received care from out-of-state physician without California license. Medical Board complaint filed simultaneously resulted in investigation of telehealth platform.

Physician Credential Misuse: Secured $25,000 settlement + removal of all unauthorized uses of physician’s name and credentials from weight loss telehealth app’s marketing materials. Platform had used physician’s profile without consent for 18 months.

Knox-Keene Compliance: Advised direct primary care startup on restructuring subscription model to avoid Knox-Keene licensure (converted from “unlimited visits” risk-bearing model to compliant “access fee + fee-for-service” structure).

DEA Investigation Defense: Defended physician employed by online prescribing platform facing DEA investigation for controlled substance prescribing. Negotiated voluntary surrender of DEA license (avoiding criminal prosecution) and exit from platform employment.

Past results do not guarantee future outcomes. Each case depends on specific facts and applicable law.

Contact Information

Attorney Sergei Tokmakov
California Healthcare Law & Telehealth Compliance
Email: owner@terms.law

Schedule consultation using Calendly widget above or contact me directly to discuss your telehealth dispute.