https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140270/, Additional Resources: The Missouri State Medical Association offers, Be sure to notify your patients regarding your retirement. When a physician retires or dies, patients should be notified and urged to find a new physician and should be informed that upon authorization, records will be sent to the new physician. In Illinois, as in many other states, patient abandonment is not only a form of malpractice; for physicians, it is also grounds for disciplinary action against ones license. Develop a plan for patient notification. Call 713-524-4267, ext. Ensuring that patients receive reasonable notification; Ensuring that patients are given an opportunity to obtain copies of their records or arrange for the transfer of their medical records to another physician; Specifying who has custodianship of the records; and, Advising how copies of the medical records may be obtained.. It is, however, not uncommon for employees to solicit the departing physician prior to departure. . As we were assembling the resources for this document, we were amazed at the level of vague, incomplete, and even inaccurate material on the internet regarding notification requirements for closing medical practices. See the bottom of this page for a state-by-state comparison of the available guidelines. It also informed URMCs workforce of its policy that information regarding continuity of care was to be communicated to patients by URMC, not the individual health care providers. 3. Further, many retirement plans have vesting schedules that depend on the number of years one has worked with the employer. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. This may be a requirement in your state, but make sure your plan also includes more effective notification methods that contain modern avenues of communicating that will more likely reach your patients. Texas Medical Board. 219, or send a letter to Harris County Medical Society, John P. McGovern Building, 1515 Hermann Dr, Houston, TX 77004-7126. The office should also consider changing its answering message to alert patients It is important to be mindful when reviewing sample closure letters floating around on the internet that most fail to consider many items beyond closure date and how to obtain copies of medical records. Understand your clients strategies and the most pressing issues they are facing. 9. A non-solicitation clause only prohibits solicitation. Accessed January 18, 2023. Who should provide the notice? There is a range of activities and provider-patient communications that can continue after an exit without breaching the non-solicitation restriction. At the same time, physicians are in high demand and have tremendous professional opportunities, ranging from starting a new practice to joining an existing one. What can I tell my patients when Im leaving my employer? Many practices obtain claims made malpractice insurance policies that insure you for claims made during your term of employment. Notification can be accomplished by a sign in the reception area, a note in the monthly billing statement, or an advertisement in a local newspaper. Continued, https://www.msbml.ms.gov/sites/default/files/Policies/3-22-19Policies.pdf, Missouri Med. Itshould not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction. Common questions include: Navigating the line between non-solicitation and patient abandonment poses a challenge. Apply Renew Maintain Practice Information All patients of record who have not requested their records 30 days before the person discontinues the medical-practice business or leaves the State must be notified by first class mail by the person to permit that persons patients to procure their records., http://delcode.delaware.gov/title24/c017/sc05/index.html, Florida Statute Title 32 Ch. Also, we advise that a letter is sent to all patients seen within the last year with the same information and possible suggestions for other physicians., State advises, It is the Boards position that due care should be exercised when closing or departing from a medical practice. According to Rule 64B8-10.002(3), FAC : A licensed physician shall keep adequate written medical records, as required by Section 458.331(1)(m), Florida Statutes, for a period of at least five years from the last patient contact; however, medical malpractice law requires records to be kept for at least seven years. 1, 2. 1. An inaugural UCF resident who served veterans as a chief resident and whose career goal is to cure diabetes is the new leader of the College of Medicine's endocrinology fellowship in greater Orlando. Professions and Occupations 32-3211 states, If the health professional terminates or sells the health professionals practice and the patients medical records will not remain in the same physical location, the procedure by which the health professional shall notify each patient in a timely manner before the health professional terminates or sells the health professionals practice in order to inform the patient regarding the future location of the patients medical records and how the patient can access those records., Arkansas Medical Society states, AMS recommends that a physician place an ad in their local newspaper announcing the closure with instructions as to how the patient can obtain copies of their medical records. Those remaining in the practice must be careful not to interfere with the departing physician fulfilling these responsibilities. In this instance, the departing physician and/or practice should send a letter notifying patients of the change, and offering to provide continuous care for the patients, or offering to transfer records to another provider upon request. On the other hand, a notice directed to specific patients that informs them that the provider is leaving the employer's practice and identifies a new practice where the patient can receive the same or similar services is much closer to the line of solicitation. For providers who form more continuous treatment relationships (e.g., surgeons providing post-operative care to a patient following a procedure), patient abandonment liability can be limited by furnishing notice of termination of the relationship. It must protect the patients medical record and not release it without patient authorization. Abandonment also occurs when a physician leaves the employment of a group practice, hospital, clinic or other health-care facility, without the physician giving reasonable notice and under circumstances which seriously impair the delivery of medical care to patients., https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/049/chapter16/chap16toc.html&d=, State advises, Publish a notice 90 days before closing a practice in a newspaper with statewide circulation, including information on how patients can get their medical records (when a physician is deceased, the heirs or the estate must give the same public notice within 90 days); Send a letter to patients that have been seen within the past year notifying them of the practice closure., https://health.ri.gov/healthcare/about/closingpractices/, State advises, Doctors should advertise in all papers, and notify all patients (no matter how long ago treated) the letter of closing. According toSchneiderman, Other medical centers, hospitals, health care providers, and health care entities should view this settlement asa warning, and take the time now to review and amend, asneeded, their own policies and procedures to better protect private patient information.. A. Texas Medical Board (TMB) regulations say a physician leaving a group must notify his or her patients by: In the newspaper of greatest general circulation in each county in which the physician practices or practiced, and in a local newspaper that serves the immediate practice area; and. The legal guidelines regarding patient notification vary for each state. (B) Placing written notice in the physician's office; AND The scope of practice of CNAs, as well as other nursing professions (RN, APRN, etc.) A physician must give notice to patients of his or her leaving or closing a practice, otherwise face a possible claim of patient abandonment. In contrast, our goal is to help closing practices gain a better understanding of the process and guidelines when it comes to patient notification. (C) Notifying patients seen in the last two years of the physician's discontinuance of practice BY EITHER: We can help you assess your rights and responsibilities. Keep the phone number of the closed practice active for a minimum of 90 days and include key information on the voicemail after the practice has closed. Readers should consult their healthcare attorney to obtain advice with respect to any legal matter. For sound guidance on regulations and requirements, retiring physicians can call the KBHA at (785) 296-7413. (i) Sending a letter to each patient; OR Through our years of experience in the custodial records field, we have worked with clients in almost every health care arena and handled the full spectrum of records management needs. The TMB has rulesprohibiting the practice or physician group from interfering. A physician in a multi-physician practice is retiring or leaving the geographic practice area. Harris County Medical Society. Can Physician Assistants Own Independent Medical Practices? A noncompete covenant may prohibit you from practicing within a certain geographic radius of your current practice for a designated period of time, often two years. Med 10.03.2 (o) states, Patient abandonment occurs when a physician without reasonable justification unilaterally withdraws from a physician-patient relationship by discontinuing a patients treatment regimen when further treatment is medically indicated and any of the following occur: 1. Except in cases of death or other incapacity of the practitioner, practitioners may not abandon a patient or abruptly withdraw from the care of a patient. Non-solicitation clauses are a type of restrictive covenant (meaning legally that they forbid a party from doing something). Are you a healthcare provider considering a new employment agreement with a non-solicitation clause? Here are several keys to handling the transition appropriately. In March 2015, the NP was preparing to leave URMC for a position at Greater Rochester Neurology (GRN). Save my name, email, and website in this browser for the next time I comment. The notice must include an explanation of how copies of the facilitys records may be accessed by patients. Title: Retention of medical records and patient notification upon closure of a practice Number: OP04 -29 References: Board Minutes January 23, 2004, April 2, 2004; November 7, 2014; September 11, 2020 . In addition, an individual letter is to be sent to each patient seen within the three years preceding the date of discontinuance of the practice., https://portal.ct.gov/DPH/Public-Health-Hearing-Office/Regulations/Public-Health-Code-Medical-Records-Regulations, Delaware Code Title 24 1761 states physicians discontinuing business: shall notify that persons patients of record by publishing a notice to that effect in a newspaper of daily circulation in the area where the person practices. Meanwhile, about one in three doctors and other health professionals say they intend to reduce work hours in the next 12 months, according to recently published survey research. Contact information that enables the patient to obtaininformation on the patient's medical records. It may also resolve the issue in advance by including a provision in the physicians written employment or other affiliation agreement that specifies the details of the notice that the health care entity will send in the event of the physicians departure. 1, Required notification of discontinuation of practice. https://www.health.ny.gov/facilities/adult_care/dear_administrator_letters/acf_closure_guidelines.htm, The North Carolina Medical Society advises, practitioners and other parties that may be involved to ensure that: patients are notified of changes in the practice, sufficiently far in advance (at least 30 days) to allow other medical care to be secured, which is often done by newspaper advertisement and by letters to patients currently under care (Sample letter Attachment A); patients clearly understand that the choice of a health care provider is the patients; patients are told how to reach any practitioner(s) remaining in practice, and when specifically requested, are told how to contact departing practitioners; and patients are told how to obtain copies of or transfer their medical records., https://www.ncmedsoc.org/wp-content/uploads/2013/06/Closing-a-Medical-Practice.pdf, Rule 4731-27-03 states, When () a health care entity provides to patients a notice of the termination of a physicians employment, the notice shall be provided in one of the following ways: (1) A letter sent via regular mail to the last address for the patient on record, with the date of mailing of the letter documented; (2) An electronic message sent via a HIPAA compliant electronic medical record system or HIPAA compliant electronic health record system that provides a means of electronic communication between the health care entity and the patient and is capable of sending the patient a notification that a message has been received and is in the patients portal., https://codes.ohio.gov/ohio-administrative-code/rule-4731-27-03, State advises, Whenever a physician is leaving or has left practice and the actual office is being closed, several different methods of patient notification can be used. The penalty was the result of a settlement with New York Attorney General Eric Schneiderman. These policies and others are discussed separately below. Physicians are under a tremendous amount of pressure in todays health care environment as costs escalate, reimbursement declines and the malpractice crisis continues. Likewise, physicians often agree to pay for tail coverage if they terminate their employment without cause. Indeed, this may be especially appropriate when the employment agreement defines patients treated by the employee as the employers. Proactive [], American Medical Association (AMA) guidelines, https://www.cms.org/uploads/BME_Policy_40-8.pdf, https://drive.google.com/file/d/0B-K5DhxXxJZbZGZUdllNbUFvdDg/view, https://www.ama-assn.org/delivering-care/ethics#Chapter%201:%20Opinions%20on%20Patient-Physician%20Relationships, https://cdn.ymaws.com/lsms.site-ym.com/resource/resmgr/resources/lsms_resource_closingamedica.pdf, http://www.lsbme.la.gov/content/health-care-resources-practitioner, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140270/, https://www.msma.org/guide-to-closing-a-medical-practice.html, https://www.njconsumeraffairs.gov/bme/Pages/FAQ.aspx, http://164.64.110.134/parts/title16/16.010.0017.html, http://www.nmms.org/wp-content/uploads/2018/08/closing_your_practice_2016_revised_-_pcs_0.pdf, https://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=22&pt=9&ch=190&rl=8, https://www.texmed.org/Template.aspx?id=6676, State offers no guidance, but association guidelines available. Don't worry, I did that on purpose. In these cases, patients do not expect the same provider to perform related services in the future. The comparison is intended to serve as a resource to help retiring physicians and closing practices navigate their obligations and avoid regulatory penalties as a result of the patient notification process. Nor would purely personal communications between the employee and patient. (ii) Sending an email to each patient, in a manner that is compliant with state and federal law. Although the Health Information Portability and Accountability Act of 1996 (HIPAA) prohibits the unauthorized disclosure of PHI, the NP disclosed the PHI to her new employer, GRN, without the patients authorization. When scheduling your departure from the practice, take reasonable steps to ensure that you are not leaving any patients in a bind. Some states would recognize a tortious interference with contract if a physician were to raid the practice for employees. While some employers will contractually agree to pay tail insurance in certain events, a thorough review of your employment agreement, and sometimes the shareholders or operating agreement, will determine who is responsible for procuring tail coverage. Is a list of patient names without information about the patients medical condition considered PHI? Texas Medical Board Rules Chapter 165.5(a)(1-3) Transfer and Disposal of Medical Records. Does a heath care practitioner have to accept new patients? established, continuing care patients who have been seen within the last year and/or patients who have future appointments scheduled) written notification of the office closure with instructions on how they may obtain access to their medical records; Place a notice on the door or near the reception desk of your practice at least 30 days in advance of the closure., https://wvbom.wv.gov/Closingordepartingpractice.asp. Section 456.057, Florida Statutes, sets forth the requirements that must be followed when a physician retires, closes his office or relocates his practice. Should patients be notified of the physicians departure? Many physicians believe these covenants will not be enforced; however, the courts in most states will uphold them if they are reasonable. This settlement addresses several questions that often arise when a physician (or other health care professional) departs a hospital or medical group (health care entity). 7. A non-solicitation provision is usually triggered only by an action. The unique facts and circumstances related to a patients condition and care should be used to determine how much notice a patient should be given prior to the actual termination of the physician-patient relationship, and whether the physician should facilitate the transfer of care to another provider., While the KBHA does not make laws, this organization works closely with both bankruptcy courts and other official state resources, appearing as both a regulatory authority and an independent agency. Prohibition Against Interference 165.5(c)(1-2)rules state that: For example, practices often agree to pay for tail coverage in the event that employment is terminated by the practice without cause. Be aware that patient lists, patient charts and other patient demographic information are property of the practice, not the departing physician. The NP was interviewed, suspended, and subsequently terminated. Post the notification on the practice website. No. You should review the details of your plan so that you do not unwittingly forfeit significant amounts of retirement money. See permissionsforcopyrightquestions and/or permission requests. Do not be seduced into foregoing the purchase of tail coverage. Accessed January 18, 2023. For instance, providers who staff emergency departments, hospitalist programs, and urgent care centers render care that is episodic in nature. Rather than include the providers new practice location, the notice may identify another provider within the practice who can continue to treat the patient. A critical criterion for patient abandonment claims is the need for further treatment. The Florida Medical Association (FMA) recommends to a practitioner who wishes to terminate a relationship that the practitioner should give the patient adequate notice in writing, and the practitioner should remain available to the patient for at least 30 days in order to allow time for the patient to find a new practitioner.
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