Before leaving, she asked for a list of patients she treated while employed at URMC, and URMC provided her with a spreadsheet containing the protected health information (PHI) of 3,403 patients. 2. She can be reached at laura-brockway@tmlt.org. Can Physician Assistants Own Independent Medical Practices? 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. TMB rules for physicians who retire, close, or leave a practice. Accessed January 18, 2023. In this way, the provider might avoid claims of patient abandonment. Accessed January 18, 2023. In our experience at Jackson LLP, rarely are any two non-solicitation clauses alike. 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 court, however, disagreed. All Rights Reserved. What is the health care entitys responsibility when a physician departs? 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 . Which patients should be notified? Rather than include the providers new practice location, the notice may identify another provider within the practice who can continue to treat the patient. In fact, you must notify them- you can't just leave and let them find out you're no longer their provider. URMC responded by sending breach notification letters to the affected patients and notifying the media. To prevent this, you need to procure a supplemental endorsement policy, commonly referred to as tail coverage, which appends to the primary policy and insures you for claims made after your employment terminates. Doing so could subject the provider to claims of abandonment by the patient. Retiring members can reference our Retirement Checklist for additional guidelines and to find information about Tribute Plan award payments. 3. 2023 Jackson LLP Healthcare Lawyers. 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. Board Rule 540-X-9-.10 states reasonable notification must be provided. 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 . 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. Some require an extraordinarily long notice period (such as one year) before the physician can qualify for deferred compensation payments. In this situation, the provider might not be precluded from soliciting that practices patients for services at the medical spa. 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. Approximately ninety days is suggested whenever possible. 1) The state has enacted law regarding patient notification. Negotiations over non-solicitation restrictions can play out like a game of tug of war. 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. 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, Additional Resources: Texas Medical Association advises, Texas Medical Board (TMB) regulations say a physician leaving a group must notify his or her patients by: Publishing a notice either: On the physicians or practices website or 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 Placing a written notice in the physicians office; and Sending patients the physician has seen in the last two years either: A notice in a letter or A notice in an email in a manner compliant with state and federal law. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); What kind of notification should or do I have to give to patients if I am retiring, Hospitals are often growing, acquiring new facilities and systems to expand their reach and services. Non-solicitation clauses are a type of restrictive covenant (meaning legally that they forbid a party from doing something). Those remaining in the practice must be careful not to interfere with the departing physician fulfilling these responsibilities. Post the notification on the practice website. 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. 6. A physician who leaves or closes a practice must notify a host of persons of the change in status. 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. Itshould not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction. 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. 2. The next generation search tool for finding the right lawyer for you. According to, Schneiderman, Other medical centers, hospitals, health care providers, and health care entities should view this settlement as, a warning, and take the time now to review and amend, as, needed, their own policies and procedures to better protect private patient information., Law Enforcement and Healthcare: When Consent, Privacy, and Safety Collide. The notice should be in the form of a letter sent to the patient, preferably certified with a return receipt requested. If you had signed a non-compete, you would refer them to the other providers in your practice. Nor would purely personal communications between the employee and patient. It is not just a piece of advice but also a legal requirement by several state and federal laws. No. (C) Notifying patients seen in the last two years of the physician's discontinuance of practice BY EITHER: 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). workforce on policies and procedures related to PHI and notify the Attorney General of future breaches. Unless your employment agreement provides otherwise, you may be able to notify patients that you are leaving the practice . Notifying patients should be done within three months in advance; thirty (30) days at minimum. 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. 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. Rarely do practices agree that patient charts are the property of the employed physician. Can a medical doctor perform acupuncture? However, weve found its always useful to clarify what exactly non-solicitation and patient abandonment mean and what they do not mean. 1) The state has enacted law regarding patient notification. 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. Determine whether solicitation of employees is prohibited. 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. Texas Medical Board. 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. 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. Its an important aspect of [], At Cariend, we understand the challenges faced by healthcare facilities in transition. The NP was interviewed, suspended, and subsequently terminated. State advises providers follow (1) AMA and (2) Louisiana State Medical Society Guidelines. We are looking for outstanding providers with leadership experience, who are committed to delivering high quality and compassionate patient care, to join our team. The first example letter for notifying patients of a physician leaving their practice comes from Medical Center Clinic. This notice shall be no less than two columns wide and no less than two inches in height. Do not be seduced into foregoing the purchase of tail coverage. According to TMB Rules Chapter 165.5(a)(1-3): When a physician retires, terminates employment, or otherwise leaves a medical practice, he or she is responsible for: (2) Notification shall be accomplished by: (A) EITHER: (i) Sending a letter to each patient; OR The physician fails to allow for patient access to or transfer of the patients health record as required by law. From tail coverage to giving notice, heres how to prepare yourself, your partners and your patients for your departure. 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. (1) Other licensed physicians remaining in the practice may not prevent the departing physician from posting notice and the sign; (2) A physician, physician group, or organization may not withhold information from a departing physician that is necessary for notification of patients. For example, some retirement plans require an employee to work the entire year prior to becoming eligible. Health care entities must be prepared for the departure of physicians and other health care professionals. If you mail notification letters to every patient and half return as undeliverable, can you feel confident that you provided reasonable notification? This will ensure that your departure date does not result in unnecessary forfeitures. 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. Some states would recognize a tortious interference with contract if a physician were to raid the practice for employees. The Texas Medical Board (TMB), in an attempt to address this issue, adopted regulations that must be followed whenever a physician leaves a group. Podiatrists are licensed and regulated by the Florida Board of Podiatric Medicine. 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. Alert your state medical board in case patients contact them for information. The employee pulls in the other direction, seeking to narrow the non-solicitation clause to reduce its impact on future work opportunities. Leaving a group practice. Common questions include: Navigating the line between non-solicitation and patient abandonment poses a challenge. In contrast, our goal is to help closing practices gain a better understanding of the process and guidelines when it comes to patient notification. (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. What if a given non-solicitation provision does not restrict a providers right to notify patients of his or her departure? 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, patient abandonment is more prone to arise from the failure to properly act. The key is to prevent patients from falling through the cracks because of tensions between the physician and the practice. The requirements of this rule shall not apply to a physician who has retired from or sold his or her medical practice if: Such physician has notified his or her active patients of retirement from or sale of practice by mail. The practice should also provide a script for receptionists on what to say. Web Design Trundlemedia, Health Insurance Portability and Accountability Act(HIPAA). In addition to sending letters, think carefully about how you will address this topic when you speak with patients. 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. A threshold requirement for a malpractice claim premised on patient abandonment is that there is a patient-provider relationship. Don't worry, I did that on purpose. For many providers, mitigating the risk of patient abandonment requires formally ending the patient-provider relationship and providing information about how to receive the same or similar services. This growth [], Filling out patient records requests at Cariend just got a whole lot easier. Litigating a covenant, either from the employer or employees perspective, is expensive. The physician will have the opportunity to mentor new physicians. 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. Your contract may contain provisions against your soliciting the employment of existing employees of the practice. Develop a plan for patient notification. These guidelines tend to put a heavy burden on the physician, leaving them to decide on their own, items such as: In all cases, even if a particular state offers no specific requirements or guidelines for closing practice notifications, every state is clear about seeking to penalize physicians for complaints of abandonment or untimely records access if the steps chosen by the physician fail to meet an unpublished standard. Most practices only close once. 1, 2. 1 Required notification of discontinuation of practice Your contract may require that you give your practice advance written notice of your departure. This can be significant, especially if you deliver babies. Ultimately, a patient always has the right to seek out a provider of their choosing. 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. 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 . leaving a practice Within 90 days after a death . 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. 2) The state offers guidelines, but without any statutory requirements or law enforcing notification practices. The health care entity, which is the party responsible for maintaining custody of the medical record, should send the notice. This may vary from practice to practice. All rights reserved. http://164.64.110.134/parts/title16/16.010.0017.html, Additional Resources: The New Mexico Medical Society offers, Closing Your Practice Guide: If a non-solicitation attempted to forbid any treatment whatsoever of patients from the employers practice, then it would likely be unenforceable in Illinois. You should review the details of your plan so that you do not unwittingly forfeit significant amounts of retirement money. Having undertaken the care of a patient, the physician may not neglect the patient. 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. https://www.leg.state.nv.us/nrs/nrs-630.html#NRS630Sec304, NH Rev Stat 329:9 Section: Med 501.02 Standards of Conduct. This blog is made for educational purposes and is not intended to be specific legal advice to any particular person. The cost of successfully defending a medical malpractice action is lifestyle altering. The KBHA serves as a great resource to physicians. Thus, their specialty naturally limits their exposure to allegations of patient abandonment when they leave their jobs. 1997) supports this understanding. These functions included taking phone calls from existing patients with treatment-related questions. Typically, a non-competition provision prohibits an employee from joining or starting a competitor business. A non-solicitation provision is usually triggered only by an action. 2. Review the practices established policies. 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. How long must a healthcare practitioner maintain a patients records? . 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. It is not just a piece of advice; several state and federal regulations make it a mandate. 3. 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. Say, for example, a provider leaves a dermatology practice to join a medical spa that performs cosmetic procedures not available at the dermatology practice. Likewise, physicians often agree to pay for tail coverage if they terminate their employment without cause. 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. 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. 1. Review all documents you have signed. Dont risk falling short on your notification message which can result in charges of abandonment. This comparative map shows the patient notification guidelines for all 50 states. 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.