These functions included taking phone calls from existing patients with treatment-related questions. 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. 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). However, weve found its always useful to clarify what exactly non-solicitation and patient abandonment mean and what they do not mean. This letter must be sent by certified mail, return receipt requested. Be aware that patient lists, patient charts and other patient demographic information are property of the practice, not the departing physician. A Coda to the Covid Pandemic: Do Local and State Closure Laws Provide Cover for Tenant Nonpayment of Rent? Sources Even without these prohibitions, you should not actively solicit the employment of existing employees, especially prior to your departure. Are you a healthcare provider considering a new employment agreement with a non-solicitation clause? Are physicians required to have a chaperone present in the room when examining patients. 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 Medical Center suspended and ultimately terminated the nurse practitioner and treated the incident as a reportable breach. Texas Medical Board Rules Chapter 165.5(a)(1-3) Transfer and Disposal of Medical Records. The content of the notice will depend upon state law. Failure to comply with the time limit requirement of this Section shall subject the denying party to expenses and reasonable attorneys fees incurred in connection with any court ordered enforcement of the provisions of this Section. We are looking for outstanding providers with leadership experience, who are committed to delivering high quality and compassionate patient care, to join our team. Rather than include the providers new practice location, the notice may identify another provider within the practice who can continue to treat the patient. 5. Review your retirement plans. By contrast, a non-solicitation provision prohibits the employee from soliciting the employers clients and personnel for other business or work opportunities. The Florida Medical Association is not affiliated with the Board of Medicine. For example, you would never want to be in a situation where you felt compelled to lie to a patient. A 24-year-old pregnant woman came to her ob-gyn with a headache and high blood pressure. Many practices obtain claims made malpractice insurance policies that insure you for claims made during your term of employment. Texas Medical Board Rules Chapter 165.5(c)(1-2) Prohibition Against Interference. 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. Contact information that enables the patient to obtaininformation on the patient's medical records. In healthcare, non-solicitation restrictions can extend to patients and other providers who refer patients to the practice or business. Mailing letters to every patient in your statutory retention window may not be effective either, especially if your state has a baseline of 7-10 years for medical records retention. Employment contracts usually reinforce this notion. If possible, consider posting your retirement in your local newspaper(s) as well as on your website and/or social media pages (if applicable). Often practices and departing physicians will agree on what to tell patients who inquire about the tenure of the departing physician. AMA 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. Texas Medical Board Rules Chapter 165.5(c)(1-2) Prohibition Against Interference. 1, Required notification of discontinuation of practice. 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. What can I tell my patients when Im leaving my employer? Texas Medical Board Rules Chapter 165.5(a)(1-3) Transfer and Disposal of Medical Records. 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. Notifying Patients of Physician Leaving Practice - PostGrid 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. 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. This makes it very unfair to a physician closing their practice and illustrates why the steps outlined here are important to help closing practices avoid trouble, ensure continuity of patient care, and achieve peace of mind. But it is highly recommend for the protection of the physician and the patient. Breaking Up is Hard to Do: Notifying Patients When a Physician Leaves If youre in one of the states where we practice, schedule a complimentary phone consultation with one of Jackson LLPs healthcare attorneys. As these examples show, non-solicitation does not mean no contact. 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. 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. Can I take a copy of my patients records with me, in case they need care from me in the future. For sound guidance on regulations and requirements, retiring physicians can call the KBHA at (785) 296-7413. At our healthcare law firm, our clients frequently voice concerns over the non-solicitation provision in their employment agreements. 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. The health care entity, which is the party responsible for maintaining custody of the medical record, should send the notice. It is not just a piece of advice but also a legal requirement by several state and federal laws. You'll quickly notice that it's actually not a letter that talks about a physician leaving, rather it's a new doctor welcome letter. These policies and others are discussed separately below. The TMB has rulesprohibiting the practice or physician group from interfering. Notices to Patients When a Physician Leaves a Group Practice The cost of successfully defending a medical malpractice action is lifestyle altering. Jennifer Bendokas, PA-C | White-Wilson Medical Center | Fort Walton Thus, non-competition and non-solicitation clauses act together to prevent an employee from stealing the employers clients and staff and starting a new venture in the same industry or field. Make sure that if there are legal guidelines in you state, that you review them. Common questions include: Navigating the line between non-solicitation and patient abandonment poses a challenge. Patient Notification Requirements for a Closing Medical Practice - Cariend The next generation search tool for finding the right lawyer for you. This is referred to as nose coverage. Can I notify my patients that I'm leaving a practice and can I tell State advises providers follow (1) AMA and (2) Louisiana State Medical Society Guidelines. These assets belong to the practice and cannot be taken by the physician without the practices consent. Texas Medical Board. 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. . 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. Post the notification on the practice website. All Rights Reserved. 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. 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. For example, practices often agree to pay for tail coverage in the event that employment is terminated by the practice without cause. We understand the process can feel daunting. (2). 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. 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 June 11, 2015, URMC reminded its workforce that all patient information was the property of URMC and could not be copied, shared, removed, or transferred without the permission of both URMC and the patient. If the practice has social media, post the notification message there as well. 219, or send a letter to Harris County Medical Society, John P. McGovern Building, 1515 Hermann Dr, Houston, TX 77004-7126. A threshold requirement for a malpractice claim premised on patient abandonment is that there is a patient-provider relationship. 2) The state offers guidelines, but without any statutory requirements or law enforcing notification practices. It must protect the patients medical record and not release it without patient authorization. If you mail notification letters to every patient and half return as undeliverable, can you feel confident that you provided reasonable notification? 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. Each state treats notification guidance differently, but their approach generally falls within four distinct categories. 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. First, ensure proper notice is provided to patients as well as all interested governmental entities and other organizations. A physician may diagnose, prescribe, and administer treatment to individuals suffering from injury or disease. 9. 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. Learn practical ways to communicate with disruptive or angry patients. Please contact [emailprotected]. [], Smart hospitals and medical facility managers already know how to capture savings in health information management by [], Hospitals and healthcare providers are aways looking for opportunities to increase savings. How to Ensure Continuity of Care If a Physician Leaves Your Practice During your review, pay careful attention to information about advance notice provisions, retirement plan details and noncompete covenants, to name a few key elements. See permissionsforcopyrightquestions and/or permission requests. URMC began receiving calls from patients who were upset that their confidential medical information had been disclosed without their permission. 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. 115(4): 325327 advises, practices must notify patients as soon as possible to facilitate continued patient care. (C) Notifying patients seen in the last two years of the physician's discontinuance of practice BY EITHER: Questions? Copyright 1997-2023 TMLT. Departing Physicians and Patient Notification - Krugliak, Wilkins For example, the Ohio Medical Board has adopted specific rules about the content of the notice, which must include the following (Rule 4731-27-03): The Ohio rules require the health care entity to send the notice to patients, but it may satisfy its statutory obligation by providing patient contact information to the departing physician and requiring the physician to send the notice to patients. Who should provide the notice? These rule changes also apply when leaving a group practice, as the departing physician is responsible for providing proper notification. When you compare any random series of practice types for example, psychiatry, dental, OB/GYN, or pain management you quickly realize a one-size-fits-all approach does not work for notifying patients of your closing practice. 1. Approximately ninety days is suggested whenever possible. Determine whether solicitation of employees is prohibited. Those remaining in the practice must be careful not to interfere with the departing physician fulfilling these responsibilities. It must protect the patients medical record and not release it without patient authorization. It does not create an attorney-client relationship between our firm and the reader. Such clauses generally cover a specific geographic area and period of time. 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. For some, challenges come from [], All businesses know that protecting vital operational data and records is paramount in the digital landscape. 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. In this way, the provider might avoid claims of patient abandonment. This content is owned by the AAFP. Further, many deferred-compensation arrangements are linked to the amount of notice given. The court, however, disagreed. California health care entities should review CMA guidance before sending the notice. Many physicians believe these covenants will not be enforced; however, the courts in most states will uphold them if they are reasonable. Mind These Legal Issues. For this reason, you should review the covenant as though it is entirely enforceable in accordance with its terms. Unprofessional conduct includes, but is not limited to, the following: (17) Abandoning a patient. 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. the state Medical Association or Board) has guidelines available. 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. Ultimately, a patient always has the right to seek out a provider of their choosing. 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. Rarely do practices agree that patient charts are the property of the employed physician. 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.