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The University of Rochester Medical Center (URMC) recently agreed to pay a $15,000 penalty for providing patient names, addresses, and diagnoses to a departing nurse practitioner (NP) without first obtaining authorization from those patients. 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., Louisiana State Medical Society Guidelines The physician cannot abandon the patient. Make reasonable efforts to directly notify patients treated within the prior six months letting the patients know about the manner in which the patient can obtain copies of his/her records. (I) Posting such notice on the physician's or practice website; OR Retiring members can reference our Retirement Checklist for additional guidelines and to find information about Tribute Plan award payments. If you mail notification letters to every patient and half return as undeliverable, can you feel confident that you provided reasonable notification? 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. Laura Hale Brockway is the Vice President of Marketing at TMLT. 2. Review the practices established policies. Those remaining in the practice must be careful not to interfere with the departing physician fulfilling these responsibilities. If you are responsible for tail coverage, you may be able to negotiate with your new practice to provide you with sufficient funds to purchase it. Cover your tail. In Ontario and Alberta, for example, at least 90 days notice is required, unless the closure is unexpected or due to circumstances beyond the physician's control, in which case the notice must be communicated as soon as reasonably possible. Notify patients in writing, through a letter carefully crafted with input from practice colleagues or the employing . Practice Information Physicians and Surgeons A Physician or Surgeon (M.D.) Has caused to be published, in the newspaper of greatest circulation in each county in which the physician practices or practiced and in a local newspaper that serves the immediate practice area, a notice which shall contain the date of such retirement or sale that offers to provide the patients records or copies thereof to another provider of the patients choice, and if the patient so requests, to the patient. Don't worry, I did that on purpose. Leaving a practice can be a stressful time in any physicians career. The health care entity has the dual role of safeguarding the medical record while facilitating continuity of care. Physicians and other healthcare providers have a duty not to expose their patients to undue harm by ending the treatment relationship in an abrupt, disruptive manner. Be aware that patient lists, patient charts and other patient demographic information are property of the practice, not the departing physician. It is the position of the Washington State Board of Osteopathic Medicine and Surgery (Board) that transition from a medical practice is done with a minimum of disruption to the patient. When an osteopathic physician leaves a group practice, the patients of that physician must be notified., https://www.doh.wa.gov/portals/1/Documents/2300/RetentionOfMedicalRecords_And_PatientNotification.pdf, State advises, When a medical practice closure timetable allows, physicians should engage in a conscious and methodical winding down of a medical practice. A long notice period is often difficult for a non-retiring physician to give, but these issues deserve consideration. California health care entities should review CMA guidance before sending the notice. Board Rule 540-X-9-.10 states reasonable notification must be provided. The usage and disclosure of patient information, including patients medical records, are often limited by another form of restrictive covenant in employment agreements: confidentiality clauses. The case of Bloomington Urological Associates, SC v. Scaglia, 686 N.E.2d 389 (Ill. App. Develop a plan for patient notification. 3. This can be significant, especially if you deliver babies. The patients of a physician who leaves a group practice should be notified that the physician is leaving the group., https://www.commerce.alaska.gov/web/portals/5/pub/MED_Guide_Retiring_Closing_Leaving_Group.pdf, Arizona Revised Statutes Title 32. What is the health care entitys responsibility when a physician departs? 2. Pursuant to the Health Information Technology for Economic and Clinical Health Act, state attorneys general are empowered to enforce HIPAA regulations through civil actions against violators. 1) The state has enacted law regarding patient notification. Copyright 2005 by the American Academy of Family Physicians. 2) The state offers guidelines, but without any statutory requirements or law enforcing notification practices. 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. We are looking for outstanding providers with leadership experience, who are committed to delivering high quality and compassionate patient care, to join our team. For example, you would not want to plan your departure during a week in which you are anticipating five deliveries. In contrast, our goal is to help closing practices gain a better understanding of the process and guidelines when it comes to patient notification. 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. For this reason, you should review the covenant as though it is entirely enforceable in accordance with its terms. workforce on policies and procedures related to PHI and notify the Attorney General of future breaches. The penalty was the result of a settlement with New York Attorney General Eric Schneiderman. Voice mail systems can also be modified to provide new contact information after the physician has departed. In any case, some of the most effective notification arrangements you can make include: As you look for notification guidance on the internet, carefully assess the credibility of the source for information. 115(4): 325327 advises, practices must notify patients as soon as possible to facilitate continued patient care. 1 Required notification of discontinuation of practice Even without these prohibitions, you should not actively solicit the employment of existing employees, especially prior to your departure. Health care entities must be prepared for the departure of physicians and other health care professionals. https://www.leg.state.nv.us/nrs/nrs-630.html#NRS630Sec304, NH Rev Stat 329:9 Section: Med 501.02 Standards of Conduct. The notification letter should be professional and nonconfrontational, and it should set a tone that aims to maintain the best possible relationship with the patient. Wyoming Administrative Code Chapter 3; Section 5 states, (b) Any physician licensed by the board who desires to relocate or close a medical practice shall notify patients of such termination, sale, or relocation and unavailability by causing to be published once during each week for four (4) consecutive weeks, in the newspaper of greatest circulation in each county in which the physician practices or practiced and in a local newspaper that serves the immediate practice area, a display advertisement which shall contain the date of termination, sale, or relocation and an address at which the records may be obtained from the physician or terminating the practice or located or from another licensed physician. TMB rules for physicians who retire, close, or leave a practice Physicians who are retiring, closing, or leaving a practice can notify patients electronically and by posting a notice on their practice website, according to rules from the Texas Medical Board (TMB). Copyright 2006 - 2023 Law Business Research. Anyone looking for information on this topic should be aware of the risk in assuming a simple internet search will provide clear and accurate information. Dont hesitate to contact an attorney if you have any questions. The notice should be in the form of a letter sent to the patient, preferably certified with a return receipt requested. 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. 2. Clearly, a provider is not susceptible to an allegation of patient abandonment each time arelationship with a patient terminates. 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. The office should also consider changing its answering message to alert patients Jennifer Bendokas, PA-C. Otolaryngology (ENT) 1110 Hospital Road Fort Walton Beach, Florida 32547 850.863.8275 Education Doctor of Medicine Science University of Lynchburg Nor would purely personal communications between the employee and patient. They worry that it will force them to abandon their established patients in violation of their legal and ethical obligations. The newspaper ad may have been effective in 1990 when daily newspaper circulation in the US was over 62 million, but with that figure now less than 20 million and declining rapidly, newspaper alone is no longer practical. According toRule 64B8-10.002(3), FAC : A licensed physician shall keep adequate written medical records, as required by Section458.331(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. Contrary to common conception, the federal Health Insurance Portability and Accountability Act(HIPAA) and similar state laws do not entitle providers to access or copies of their employers patient information and records. The court, however, disagreed. Many states require that patients be notified when a physician is departing a practice. If you would like to learn how Lexology can drive your content marketing strategy forward, please email [emailprotected]. You may start by searching for your state requirements, but quickly end up at a third-part source that has paraphrased or misinterpreted the laws. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. The practice should also provide a script for receptionists on what to say. The notice to patients should be a minimum of 30 days. The radius is usually determined by your practices location and could range from five miles in a suburban area to 50 miles or more in a rural area. The KBHA serves as a great resource to physicians. Please contact [emailprotected]. 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. 4. Review advance notice provisions. Many physicians believe these covenants will not be enforced; however, the courts in most states will uphold them if they are reasonable. A clean departure will save you headaches and possibly dollars in the immediate future and in the long run. The notice shall appear twice, seven days apart. 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. In March 2015, the NP was preparing to leave URMC for a position at Greater Rochester Neurology (GRN). 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.. Many practices obtain claims made malpractice insurance policies that insure you for claims made during your term of employment. This letter must be sent by certified mail, return receipt requested. 6. 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. On the other hand, a notice directed to specific patients that informs them that the provider is leaving the employers practice and identifies a new practice where the patient can receive the same or similar services is much closer to the line of solicitation. Is a list of patient names without information about the patients medical condition considered PHI? 1) The state has enacted law regarding patient notification. The physician fails to provide for continuity of prescription medications between the notice of intent to withdraw from the physician-patient relationship and the date on which the physician-patient relationship ends, if the prescription medications are necessary to avoid unacceptable risk of harm. The notice must include an explanation of how copies of the facilitys records may be accessed by patients. The notice must include at least the following information: (1) a notice to the patient that the physician will no longer be practicing medicine as an employee of the health care entity and the date on which the physician ceased or will cease to practice as an employee of the health care entity; (2) except where the health care entity has a . The FMA also . TMB rules for physicians who retire, close, or leave a practice. A non-solicitation restriction may prevent the provider from issuing such notice directly. This must be done by placing a notice in a daily local newspaper published in the community which is the prime locus of the practice. The NP was interviewed, suspended, and subsequently terminated. 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. There is a range of activities and provider-patient communications that can continue after an exit without breaching the non-solicitation restriction. How to text patients and colleagues without violating the Health Insurance Portability and Accountability Act. Review your content's performance and reach. 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.