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. Principles of Medical Ethics Opinion 1.1.5 (1) Notify the patient far enough in advance to permit the patient to secure another physician; and (2) Facilitate transfer of care when appropriate. You should review the details of your plan so that you do not unwittingly forfeit significant amounts of retirement money. That case involved a dispute over a non-compete in a urologists employment agreement. Can a medical doctor work as a chiropractor? A physician may diagnose, prescribe, and administer treatment to individuals suffering from injury or disease. Some states even require or suggest 30 days prior written notice before a departure so that patients will have sufficient time to transfer their records if they desire to change physicians. Notify patients in writing, through a letter carefully crafted with input from practice colleagues or the employing . 2) The state offers guidelines, but without any statutory requirements or law enforcing notification practices. Keep a step ahead of your key competitors and benchmark against them. 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. Is a list of patient names without information about the patients medical condition considered PHI? 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. Clearly, a provider is not susceptible to an allegation of patient abandonment each time arelationship with a patient terminates. Regardless of the state you are in, best practice for physicians is to provide ample notice to their patients regarding changes in practice or closure. Many physicians believe these covenants will not be enforced; however, the courts in most states will uphold them if they are reasonable. Accessed January 18, 2023. . is regulated by the Florida Board of Nursing. 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. 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. In these cases, patients do not expect the same provider to perform related services in the future. When preparing your notifications: Looking at the closing medical practice notification guidelines of all 50 states, some are silent on providing guidance, while others provide a vague range of recommendations. 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. An official letter to your patients is highly recommended. The answer is yes. Copyright 1997-2023 TMLT. 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. For example, practices often agree to pay for tail coverage in the event that employment is terminated by the practice without cause. (C) Notifying patients seen in the last two years of the physician's discontinuance of practice BY EITHER: 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. 2. When scheduling your departure from the practice, take reasonable steps to ensure that you are not leaving any patients in a bind. URMC responded by sending breach notification letters to the affected patients and notifying the media. At our healthcare law firm, our clients frequently voice concerns over the non-solicitation provision in their employment agreements. A non-solicitation clause only prohibits solicitation. The notice must include an explanation of how copies of the facilitys records may be accessed by patients. Texas Medical Board Rules Chapter 165.5(a)(1-3) Transfer and Disposal of Medical Records. URMC also obtained an attestation from GRN that all PHI transmitted by URMC had been returned or deleted. Texas Medical Board Rules Chapter 165.5(c)(1-2) Prohibition Against Interference. Understand who owns the chart. Here are several keys to handling the transition appropriately. 1) The state has enacted law regarding patient notification. 8. At the mediation, the single specialty practice initially took the position that: (1) if a patient contacted them asking for an appointment with one of the departing physicians, the practice would . Prohibition Against Interference 165.5(c)(1-2)rules state that: Physicians are generally required to notify patients directly through one or more channels . Each state treats notification guidance differently, but their approach generally falls within four distinct categories. 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. It must protect the patients medical record and not release it without patient authorization. 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 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. 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. A number of patients called the Medical Center and complained about the letter they received. All rights reserved, Prohibition Against Interference 165.5(c)(1-2). 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. 1 Required notification of discontinuation of practice These policies and others are discussed separately below. The Medical Center suspended and ultimately terminated the nurse practitioner and treated the incident as a reportable breach. Some states would recognize a tortious interference with contract if a physician were to raid the practice for employees. Notify other patients who won't be receiving a letter by placing a notice in the local newspaper with the largest circulation, putting a sign up in the lobby and preparing a patient handout. According to the urologists former employer, such activities violated the non-compete. 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. 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. Board Rule 540-X-9-.10 states reasonable notification must be provided. Dont hesitate to contact an attorney if you have any questions. 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. 2. Review the practices established policies. Once a decision has been made to discharge a patient from the p ractice, the practice will need to notify the patient of the termination in writing. This is done so patients cannot sue for abandonment. To avoid charges of abandonment, youll need to send a letter to active patients., https://www.llr.sc.gov/med/Policies/ClosingOffice.pdf, South Dakota Codified Law (SDCL) 44:04:09:11 states, At least 30 days before closure, the health care facility must notify the department in writing indicating the provisions for the safe preservation of medical or care records and their location and publish in a local newspaper the location and disposition arrangements of the medical or care records., https://sdlegislature.gov/api/Rules/Archived/1540.pdf, Texas Administrative Code Rule 190.8 22:9:190: b states, Practice Inconsistent with Public Health and Welfare. While the Board rule does not specify the mode of notification, it would be difficult to ensure patients received notification by a newspaper ad. Your contract may require that you give your practice advance written notice of your departure. A critical criterion for patient abandonment claims is the need for further treatment. The analysis will always depend on the particular circumstances involved. Can a heath care practitioner refuse to treat a patient? Rarely do practices agree that patient charts are the property of the employed physician. 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 . This content is owned by the AAFP. 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. https://www.ilga.gov/legislation/publicacts/fulltext.asp?Name=093-0087, Indiana Administrative Code 844 IAC 5-2-16 states, A practitioner, upon his/her retirement, or upon discontinuation of the practice of medicine or osteopathic medicine, or upon leaving or moving from a community, shall notify all of his/her active patients in writing, or by publication once a week for three (3) consecutive weeks in a newspaper of general circulation in the community, that he/she intends to discontinue his/her practice of medicine or osteopathic medicine in the community, and shall encourage his/her patients to seek the services of another practitioner., https://www.in.gov/pla/professions/medical-licensing-board-of-indiana/public-notices/practice-related-faqs/, Iowa Administrative Code 13.7(1) states, Termination of the physician-patient relationship. 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. The scope of practice of CNAs, as well as other nursing professions (RN, APRN, etc.) Leaving a group practice. However, it at least informs the patients that the provider is not responsible for their further care. Likewise, physicians often agree to pay for tail coverage if they terminate their employment without cause. Contact managed care companies with whom you have contracts. Notice to Patients on the Departure of a Physician September 2007 Texas Medical Board Regulations When a physician departs a group, the issue of continuity of care for patients should be considered. 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. Another helpful approach, particularly for specialized physicians, is to provide referrals to nearby practices or physicians offering similar types of care or services. If you didn't sign a non-compete agreement, you can notify your patients that you're leaving and tell them where you're moving. (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 health care entity, which is the party responsible for maintaining custody of the medical record, should send the notice. Health care entities must be prepared for the departure of physicians and other health care professionals. 1. Accessed January 18, 2023. a physician departing a practice to notify her patients that the physician is leaving, the address of the new practice, and offer the patient the opportunity to have medical records forwarded to the new practice. In this situation, the provider might not be precluded from soliciting that practices patients for services at the medical spa. Texas Medical Board. Unless your employment agreement provides otherwise, you may be able to notify patients that you are leaving the practice . Mind These Legal Issues. In this way, the provider might avoid claims of patient abandonment. If you are asking your partner to leave, you need to know the practices rights and obligations to him or her. As these examples show, non-solicitation does not mean no contact. 219, or send a letter to Harris County Medical Society, John P. McGovern Building, 1515 Hermann Dr, Houston, TX 77004-7126. For determining your best course of action on notification, rely on an experienced custodial records provider that can share examples of what others have done, participate in a dialog with your malpractice insurer or healthcare attorney, and determine what is best for your specific practice type and patients in order to balance cost, patient care, and reasonability. This blog is made for educational purposes and is not intended to be specific legal advice to any particular person. This example is conceptual. The cost of successfully defending a medical malpractice action is lifestyle altering. If the restrictive covenant specifically prohibits the physician from treating patients he saw while employed with his former employer, there is case law that indicates a physician may not be able to treat the patient regardless of who establishes first contact. The provider might still face constraints in accessing patients addresses and other information. Alert your state medical board in case patients contact them for information. 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. 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. 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 . A non-solicitation restriction may prevent the provider from issuing such notice directly. Practice Information Physicians and Surgeons A Physician or Surgeon (M.D.) Web Design Trundlemedia, Health Insurance Portability and Accountability Act(HIPAA). Copyright 2006 - 2023 Law Business Research. Having undertaken the care of a patient, the physician may not neglect the patient. This notice shall be no less than two columns wide and no less than two inches in height. 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. You and the practice have an obligation to provide proper care for your patients. Whether the practice pays for tail coverage often depends on the type of termination effected. 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. Notifying Patients of Practice Closure When closing a practice, you should send a notification letter to the patients you have seen in your practice within the last three years. A physician in a multi-physician practice is retiring or leaving the geographic practice area. Recent changes to Board rule 165.5 have expanded the exceptions to providing notice to patients.. A physician is not required to provide notice of his or her discontinuation of practice to patients if the physician: treated the patient while in a locum tenens position at a practice location for a period of no longer than six months at that location. But it is highly recommend for the protection of the physician and the patient. Some require an extraordinarily long notice period (such as one year) before the physician can qualify for deferred compensation payments. 2, When requested, the practice should provide the departing physician with the contact information of his/her patients to ensure the departing physician is allowed to fulfill patient notification responsibilities, and to avoid TMB disciplinary sanctions for the remaining physicians and possible legal risk to the practice. 3. 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). 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. Approximately ninety days is suggested whenever possible. 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. In healthcare, non-solicitation restrictions can extend to patients and other providers who refer patients to the practice or business. 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. 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. Should patients be notified of the physicians departure? State advises, Complaints of patient abandonment or neglect can be avoided by giving patients sufficient notice of the practice closure. 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. State advises providers follow (1) AMA and (2) Louisiana State Medical Society Guidelines. Yes. These assets belong to the practice and cannot be taken by the physician without the practices consent. 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. Supreme Court Decision Impacts FLSAs Overtime Rules, Update on San Franciscos Treatment of Vacant Properties, 2023 Filing Requirements and Contribution Limits for California Major Donors, Checklist: Processor due diligence (data protection and cybersecurity) (UK), Checklist: Obtaining and managing consent under the GDPR (UK), Checklist: Assessing whether an organisation is a controller or processor under the GDPR (UK), Notice to the patient that the physician will no longer be practicing medicine at the health care entity, The date the physician ceased or will cease to provide medicine services at the health care entity, If the physician will be practicing medicine in another location,contact information for the physician subsequent to leaving the health care entity, Contact information for an alternative physician or physiciansemployed by the health care entity or contact information for a group practice that can provide care for the patient. Dont risk falling short on your notification message which can result in charges of abandonment. See the bottom of this page for a state-by-state comparison of the available guidelines. The Texas Medical Board (TMB), in an attempt to address this issue, adopted regulations that must be followed whenever a physician leaves a group. Many practices obtain claims made malpractice insurance policies that insure you for claims made during your term of employment. Doing so could subject the provider to claims of abandonment by the patient. Each patient should receive a letter and notices should appear in local newspapers at least three times over a few months or more. 3. Some states dont specifically list steps for closing a practice, but simply note the requirements for terminating a physicians relationship to patients. It is not just a piece of advice but also a legal requirement by several state and federal laws. Since most patients do not receive a monthly notice, it is common practice to place a dignified advertisement in two or three editions of the local newspaper notifying the general public, as well as past and present patients., https://apps.ok.gov/osboe/documents/Closing%20DO%20Office.pdf, State advises, If you plan to cease the practice of medicine in Oregon, you are required to ensure safe storage and access to patient records. Texas Medical Board. 7.03. Abandonment is the unilateral termination of the physician-patient relationship by the physician without giving the patient adequate notice of such termination and without giving the patient sufficient time to establish a relationship with a new physician. Continued. 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. Podiatrists are licensed and regulated by the Florida Board of Podiatric Medicine. 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. workforce on policies and procedures related to PHI and notify the Attorney General of future breaches. https://www.leg.state.nv.us/nrs/nrs-630.html#NRS630Sec304, NH Rev Stat 329:9 Section: Med 501.02 Standards of Conduct. https://www.texmed.org/Template.aspx?id=6676, The Vermont Guide to Healthcare Law by the Vermont Medical Society advises, In order to avoid a claim of abandonment, the physician should take several steps to terminate the physician-patient relationship. The next generation search tool for finding the right lawyer for you. If youre in one of the states where we practice, schedule a complimentary phone consultation with one of Jackson LLPs healthcare attorneys. The key is that the notice affords a reasonable time to find substitute care., See our related video, Patient Abandonment.. 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. The following are best practices for notifying patients: Send current patients (i.e. Perhaps youre already a party to a non-solicitation agreement, and youre wondering how it will affect your future opportunities. You should note, however, that most states allow a patient to request that his or her chart be forwarded to a departing physician, in which case the physician can, at that time, receive the chart from the practice. 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. Once the relationship is formed, Illinois courts consider abandonment to occur when the provider refuses to treat [the] patient [while] needing further treatment, without giving the patient a reasonable time to find substitute care. As a result of such abandonment, the patient must suffer injury. Learn practical ways to communicate with disruptive or angry patients. This will ensure that your departure date does not result in unnecessary forfeitures. It may, if it chooses, permit the physician to have input as to the text of the notice. The TMB has rulesprohibiting the practice or physician group from interfering. The American Medical Associations 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., Health care entities must be prepared for the departure of physicians and other health care professionals. A physician shall ensure that emergency medical care is available to the patient during the 30-day period following notice of the termination of the physician-patient relationship., https://www.legis.iowa.gov/docs/iac/rule/09-22-2010.653.13.7.pdf, Kansas Board of Healing Arts (a regulatory board created by legislature for the purpose of education, administration, regulation enforcement) advises providers follow AMA Guidelines. The penalty was the result of a settlement with New York Attorney General Eric Schneiderman. Can a medical doctor perform acupuncture? Texas Medical Liability Trust Resource Hub, 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). For assistance, members of The Doctors Company can contact a patient safety risk manager at (800) 421-2368 or by email. Make sure that if there are legal guidelines in you state, that you review them. The settlement arose from events in the spring of 2015.