How long must a healthcare practitioner maintain a patients records? The Medical Center suspended and ultimately terminated the nurse practitioner and treated the incident as a reportable breach. Just because a provider ends patient relationships following termination of employment and cannot, by contract, solicit the employers patients for further treatment, does not mean that the provider is necessarily at risk of liability for patient abandonment. The American Medical Association's Ethical Opinion E-7.03 provides that "[t]he patients of a physician who leaves a group practice should be notified that the physician is leaving the group . Mustafa Kinaan has shown his dedication to the Central Florida community throughout his graduate medical education (GME) journey. HIPAA protects information that relates to the past, present, or future physical or mental health or condition of an individual when there is a reasonable basis to believe the information can identify the individual. 2. Review the practices established policies.
4 Compliant Examples of Letters for Notifying Patients of Physician 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. Contact managed care companies with whom you have contracts. First, ensure proper notice is provided to patients as well as all interested governmental entities and other organizations.
The Intersection Between Non-Solicitation and Patient Abandonment In April 2015, GRN sent letters to the patients whose names were on the spreadsheet announcing that the NP had joined the practice and advising them of how to switch to GRN. What if a given non-solicitation provision does not restrict a providers right to notify patients of his or her departure? 2023 Jackson LLP Healthcare Lawyers. She can be reached at laura-brockway@tmlt.org. We can help you assess your rights and responsibilities. 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. The employer pulls in one direction, seeking to draft the non-solicitation clause broadly to protect against internal poaching of clients and staff. Harris County Medical Society. See permissionsforcopyrightquestions and/or permission requests. (4) Notices placed in the physician's office shall be placed in a conspicuous location in or on the facade of the physician's office as a sign announcing the termination, sale or relocation of the practice. The FMA also recommends that the practitioner terminating the relationship should provide assistance in locating another practitioner for the patient. When Would My Healthcare Practice Use a Promissory Note?
Training Tomorrow's Health Leaders | University of Central Florida News The notice to patients should be a minimum of 30 days. Not only does this ensure a smooth transition from the current physician to the new treating physician, but it also reduces the liability of patient abandonment. Therefore, to ensure this occurs with a minimum of disruption in continuity of care, the physician terminating the physician-patient relationship should notify patients sufficiently in advance., https://www.mbc.ca.gov/Licensees/Close_Practice.aspx. This means that if a malpractice event occurs during your employment but the claim is not filed until after you have left the practice, the malpractice insurer will not cover that claim because it was not made during your term of employment. In addition to paying a $15,000 penalty, URMC agreed to train itsworkforce on policies and procedures related to PHI and notify the Attorney General of future breaches. A physician may diagnose, prescribe, and administer treatment to individuals suffering from injury or disease. Doing so could subject the provider to claims of abandonment by the patient. Say, for example, a provider leaves a dermatology practice to join a medical spa that performs cosmetic procedures not available at the dermatology practice. Many states require that patients be notified when a physician is departing a practice. Among the factors in the decision, the court concluded that physicians obligations not to commit patient abandonment militated against interpreting the non-compete as the employer proposed, stating: To conclude that telephone inquiries from existing patients to their physician constitute the practice of medicine in the context of a restrictive covenant would effectively force a physician to neglect or abandon his patients whenever they telephone or page him with medical-related questions, concerns, or emergencies at a time when he happens to be in the restricted geographical area. The notice shall provide the patient with 30 days to request a copy of his or her record or to designate where he or she would like his or her medical records transferred and shall request from the patient within 30 days written authorization for the destruction of his or her medical records., http://www.legislature.mi.gov/(S(qm1p2yrrhuxenh2d4yfgk1dd))/mileg.aspx?page=GetObject&objectname=mcl-333-16213, Mississippi State Board of Medical Licensure Policy 3.17 advises, whether by relocation, retirement, disability or death, the patient should be advised of the right to have the medical records sent to the physician of their choice. Dr. Randolph Zuber and his son defense attorney Blake Zuber have a long history of service to TMLT and the physicians of Texas, We are sad to announce the death of Randolph Clark Zuber, MD, a founder and member of our first Governing Board. BUT, the practice has a right to protect its patient list and other confidential data. State advises, the following requirements regarding closures must be met: each patient, resident, next of kin, physician and sponsor must be notified immediately upon receipt of the Department of Healths approval. Many states defer to their state medical society or American Medical Association (AMA) guidelines, which are not legal requirements, and typically do not cover all of the potential variables that may exist in your situation. Save my name, email, and website in this browser for the next time I comment. In addition to sending letters, think carefully about how you will address this topic when you speak with patients. 4. Review advance notice provisions. Another helpful approach, particularly for specialized physicians, is to provide referrals to nearby practices or physicians offering similar types of care or services. Drafting the Notification Letter . The first example letter for notifying patients of a physician leaving their practice comes from Medical Center Clinic. http://www.nmms.org/wp-content/uploads/2018/08/closing_your_practice_2016_revised_-_pcs_0.pdf. Ultimately, a patient always has the right to seek out a provider of their choosing.
Can I notify my patients that I'm leaving a practice and can I tell If you fail to give notice, the practice could claim breach of contract, with damages equal to the cost of hiring a locum tenens physician to fulfill the remainder of your term. A physician may choose whom to serve. Indeed, this may be especially appropriate when the employment agreement defines patients treated by the employee as the employers. Below we share both guidance from the State Board of Medical Examiners and information available from the Department of Regulatory Agencies (DORA) indicating regulatory penalties that could be assigned for not ensuring patient access to records. The cost of successfully defending a medical malpractice action is lifestyle altering. For the states that do not offer specific guidance on closing a medical facility and simply defer to AMA or state medical society guidelines, understand these are third-party sources are merely providing general guidance, and not legal or practice-specific advice. Further, many retirement plans have vesting schedules that depend on the number of years one has worked with the employer. https://regulations.justia.com/states/wyoming/medicine-board-of/medicine-board-of/chapter-3/section-5/. Keep a step ahead of your key competitors and benchmark against them. A practice may opt to send a letter to patients about the departure of a physician, but is generally not legally required to do so, and a physician also generally has no legal right to send such letter independently in violation of their contract (and using a practice patient list). A Coda to the Covid Pandemic: Do Local and State Closure Laws Provide Cover for Tenant Nonpayment of Rent? URMC also obtained an attestation from GRN that all PHI transmitted by URMC had been returned or deleted. That case involved a dispute over a non-compete in a urologists employment agreement. Some states dont specifically list steps for closing a practice, but simply note the requirements for terminating a physicians relationship to patients. Mind These Legal Issues. The content of the notice will depend upon state law. 1, Required notification of discontinuation of practice. (i) Sending a letter to each patient; OR State advises, Complaints of patient abandonment or neglect can be avoided by giving patients sufficient notice of the practice closure. If you are planning to make such a move, or to ask one of your partners to leave, follow these steps to avoid getting burned. Nevada Revised Statues (NRS) 630.304 states, The following acts, among others, constitute grounds for initiating disciplinary action or denying licensure: (7) Terminating the medical care of a patient without adequate notice or without making other arrangements for the continued care of the patient. As this case shows, the interests of an employer in enforcing a restrictive covenant must be balanced by a providers duty not to abandon their patients. Often practices and departing physicians will agree on what to tell patients who inquire about the tenure of the departing physician. Every state has a long list of requirements to obtain and maintain a license to practice medicine, but when it comes to closing a practice, most states only offer (at best) guidelines for what to do when ending a practice, and some states offer no guidance at all. However, there are several other elements that could be helpful to your patients as they are searching for their next provider, having their medications refilled, or other specific needs related to continuation of care.
456 057 subsection 13 states, records owners shall place an advertisement in the local newspaper or notify patients, in writing, when they are terminating practice, retiring, or relocating, and no longer available to patients, and offer patients the opportunity to obtain a copy of their medical record., https://www.flsenate.gov/Laws/Statutes/2011/456.057, Rule 360 3-.02 (16) states, O.C.G.A 43-1-19 and 43-34-37 authorize the Board to take disciplinary action against licensees for unprofessional conduct. Unprofessional conduct shall include, but not be limited to, the following: Failing to maintain patient records documenting the course of the patients medical evaluation, treatment, and response. Illinois General Assembly Public Act 84-7; 92-228 states health care facilities must provide the public with at least 30 days prior notice of the closure of the facility. For example, including the date in which your Drug Enforcement Administration (DEA) license will expire within the notification message could help patients avoid unexpected disruptions in access to life-saving medications. Chiropractors are licensed and regulated by the Florida Board of Chiropractic Medicine. But it is highly recommend for the protection of the physician and the patient. 1. Review all documents you have signed. Copyright 1997-2023 TMLT. 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. 1. Many practices obtain claims made malpractice insurance policies that insure you for claims made during your term of employment. Physicians are under a tremendous amount of pressure in todays health care environment as costs escalate, reimbursement declines and the malpractice crisis continues. Employment contracts usually reinforce this notion. 1, 2. The Florida Medical Association is not affiliated with the Board of Medicine. A critical criterion for patient abandonment claims is the need for further treatment. Negotiations over non-solicitation restrictions can play out like a game of tug of war. Notifying Patients of a Doctor's Retirement You may have observed that communicating with your patients about your leaving is essential in each of the processes we covered above. The notice must be published at least 1 time per month over a 3-month period in advance of discontinuing the business or leaving the State and must explain how a patient can procure that patients patient records. 1) The state has enacted law regarding patient notification. Offer to send copies of their medical records to their new physician and include an authorization for release of medical records., https://health.maryland.gov/mbpme/Pages/patientabandon.aspx, Michigan Public Health Code 333 16213(3)(b) states, licensee or the personal representative of the licensee, if the licensee is deceased, sends a written notice to the last known address of each patient for whom he or she has provided medical services and receives written authorization from the patient or his or her authorized representative, destroy the records required under subsection (1). URMC began receiving calls from patients who were upset that their confidential medical information had been disclosed without their permission. 7. Failure to practice in an acceptable professional manner consistent with public health and welfare within the meaning of the Act includes, but is not limited to: (j) termination of patient care without providing reasonable notice to the patient. A physician can perform acupuncture under his/her medical license as long as he/she is properly trained and educated in the field of acupuncture. 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. A health care practitioner can terminate a patient relationship at any time, but the practitioner may not abandon a patient and should provide continuity of care in accordance with the prevailing professional standard of care. All rights reserved, Prohibition Against Interference 165.5(c)(1-2). What is the health care entitys responsibility when a physician departs? 3. A non-solicitation provision is usually triggered only by an action. In addition to reviewing any documents you have signed, you should review any of the practices policies applicable to employment and departures. All Rights Reserved. Determine whether solicitation of employees is prohibited. Such clauses generally cover a specific geographic area and period of time. 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. At Cariend, [], When physicians retire or close their practice, there are many tasks to complete to ensure the process [], No matter the size or scope of their operations, hospitals and medical facilities are driven to reduce [], Hospital and medical facility managers recognize EMR systems as a necessary part of managing patient medical data. Are physicians required to have a chaperone present in the room when examining patients. . The FMA also . Provide notice to those active patients which explains that the licensee is no longer available to them, b. Further, many deferred-compensation arrangements are linked to the amount of notice given.
PDF Retention of medical records and patient information upon closure of a 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. A letter placed in the patients monthly billing notice is one method.
Starting, Closing, or Selling a Practice | AAFP It must protect the patients medical record and not release it without patient authorization. If you had signed a non-compete, you would refer them to the other providers in your practice. Notify Third Parties Dependent upon the provisions of contracts and state law, the insured physician and practice may need to notify various third parties. Copyright 2023 American Academy of Family Physicians. Even if a communication is arguably solicitous, it might fall outside the scope of a non-solicitation clause if it pertains to services not offered by the employer. Laura Hale Brockway is the Vice President of Marketing at TMLT. 2. 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. A physician shall provide a patient written notice of the termination of the physician-patient relationship. Does a heath care practitioner have to accept new patients? Whether the practice pays for tail coverage often depends on the type of termination effected. Assuming the physician is leaving the practice on good terms and with ample time to prepare for the departure, the key consideration is ensuring that patients are properly notified in a timely and professional manner. For this reason, you should review the covenant as though it is entirely enforceable in accordance with its terms. Such an approach may frustrate the provider who is leaving. Practice fined for response to social media review, Dallas dental practice fined $10,000 after publishing PHI in response to a patient review on Yelp, Texting patients while staying HIPAA compliant. After all, employers typically exclude information that might prompt patients to seek the outgoing providers services at a new practice. The office should notify patients as soon as possible to support continuity of care for the deceased physicians patients.2 As a first priority, the office staff should call patients with scheduled appointments so patients with immediate needs for a physician can find another healthcare provider. We understand the process can feel daunting. Can Physician Assistants Own Independent Medical Practices? The TMB has rulesprohibiting the practice or physician group from interfering. Readers should consult their healthcare attorney to obtain advice with respect to any legal matter. 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.