Extortion is addressed in state criminal codes and the evidentiary bar for making that sort of charge "stick" is pretty high. That said, there are some sets of facts reported by persons embroiled with PHP's that may warrant criminal prosecution if a state or local prosecutor can be convinced.

That said, these actions of state medical boards (ADA Title II) and state PHP monopolies (usually ADA Title III) are taken with deliberate indifference to decades of ADA law. ADA Title V applies to all other sections of the ADA and specifically eliminates 11th Amendment barriers to lawsuits against state agencies and identifies the transgressions of coercion, retaliation, and interference are causes of action.

Any "pushback" against a PHP treatment plan, a PHP claim of non-compliance, the financial barriers of these courses of coerced treatment, a medical board action on illegal questionnaire responses, a medical board defining having a condition that causes no current impairment as "unprofessional conduct", and related actions are common examples of a physician seeking to assert their civil rights granted under federal statute.

If those civil rights emerge from ADA Titles I, II, or III, and if a physician experiences retaliation or coercion in asserting them, or if a state medical board or PHP interferes with an interactive process to reach a reasonable accommodation, the interference is actionable on its own. ADA Title V "interference" claims are some of the fastest growing types of ADA claims.

Now of course, in most sectors, an agency appeal to an ADA/504 Coordinator could be undertaken using the published grievance process and administrative remedies may correct the problem. The availability of such administrative remedies is the intent of 28 CFR 35.107.

The problem is that state medical boards and state PHP monopolies rarely if ever have ADA/504 Coordinators and published grievance procedures. One might wonder whether these organizations assume that ADA does not apply to them.

Or, their mindset may simply be: "Of course we are breaking the law. If you want to do something about it, you can always sue us."

I believe that this "new normal" of flagrant ADA violations by PHP's and medical boards will only change in the face of diligently-pursued litigation by, or on behalf of, physicians. PHP's and boards will not stop breaking the law until they are forced to stop.