The Florida Medical Association is not affiliated with the Board of Medicine. 4. Review advance notice provisions. We understand the process can feel daunting. It is critical that you understand what you have promised to do and what has been promised to you via these documents. Most practices only close once. Additional Resources: The Kansas Medical Society advises physician, Develop and send a letter notifying patients of closing date and contact information of the custodian., https://www.kmsonline.org/resources/practice-operations/26-general-topics/120-transitioning-a-medical-practice. 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. Can a medical doctor perform acupuncture? Physicians are under a tremendous amount of pressure in todays health care environment as costs escalate, reimbursement declines and the malpractice crisis continues. 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. The employee pulls in the other direction, seeking to narrow the non-solicitation clause to reduce its impact on future work opportunities. However, the provider can arrange for the employer to give the notice on the providers behalf. Keep a step ahead of your key competitors and benchmark against them. 4 Compliant Examples of Letters for Notifying Patients of Physician Many states require that patients be notified when a physician is departing a practice. Rather than include the providers new practice location, the notice may identify another provider within the practice who can continue to treat the patient. A non-solicitation provision is usually triggered only by an action. [], 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. Section 456.057, Florida Statutes, sets forth the requirements that must be followed when a physician retires, closes his office or relocates his practice. 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. Except in cases of death or other incapacity of the practitioner, practitioners may not abandon a patient or abruptly withdraw from the care of a patient. 1. Review all documents you have signed. 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. State advises providers follow (1) AMA and (2) Louisiana State Medical Society Guidelines. 3. A physician may choose whom to serve. The following are best practices for notifying patients: Send current patients (i.e. Ultimately, a patient always has the right to seek out a provider of their choosing. It must protect the patients medical record and not release it without patient authorization. The answer is yes. 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. These rule changes also apply when leaving a group practice, as the departing physician is responsible for providing proper notification. Although he did not directly treat any patients within the restricted geography, the urologist did perform various administrative functions relating to his practice out of a home office with that radius. When Physicians Leave a Practice: Seven Keys to a Smooth Transition 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. is an individual issued a license allowing them to practice medicine. Another helpful approach, particularly for specialized physicians, is to provide referrals to nearby practices or physicians offering similar types of care or services. The statute adopts the concept of a "records owner." A "records owner" may or may not be a physician. 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. 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. Contact managed care companies with whom you have contracts. URMC began receiving calls from patients who were upset that their confidential medical information had been disclosed without their permission. You should: (1) Notify patients by letter that your practice will end and give the effective date (2) Notify patients of the record location and how to access them (3) Advise patients that they must seek the services of another health care provider or refer them to another provider (4) Advise patients that their records will be forwarded to the provider of their choice upon receipt of a properly signed release form., https://www.oregon.gov/omb/Topics-of-Interest/Pages/Patient-Records.aspx, Pa. Code 16.61(a)(17) states, (a) A Board-regulated practitioner who engages in unprofessional or immoral conduct is subject to disciplinary action under section 41 of the act (63 P. S. 422.41). 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. This may vary from practice to practice. 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. If the practice has social media, post the notification message there as well. The legal guidelines regarding patient notification vary for each state. 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. 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. Who should provide the notice? At the same time, physicians are in high demand and have tremendous professional opportunities, ranging from starting a new practice to joining an existing one. is regulated by the Florida Board of Nursing. In these cases, patients do not expect the same provider to perform related services in the future. If you use certified, return receipt mail, you can place a copy of the letter and return receipt in the patients file in case there is ever an issue of notification., https://www.albme.gov/resources/licensees/practice-issues, Alaska State Medical Board adopted AMA policy No. Medicine's great resignation? 1 in 5 doctors plan exit in 2 years How to Ensure Continuity of Care If a Physician Leaves Your Practice 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 Mind These Legal Issues. Further, many retirement plans have vesting schedules that depend on the number of years one has worked with the employer. BUT, the practice has a right to protect its patient list and other confidential data. Some require an extraordinarily long notice period (such as one year) before the physician can qualify for deferred compensation payments. 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. 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. Laura Hale Brockway is the Vice President of Marketing at TMLT. Dont risk falling short on your notification message which can result in charges of abandonment. https://regulations.justia.com/states/wyoming/medicine-board-of/medicine-board-of/chapter-3/section-5/. Some states even require or suggest 30 days prior written notice before a departure so that. A letter placed in the patients monthly billing notice is one method. the state Medical Association or Board) has guidelines available. A physician who leaves or closes a practice must notify a host of persons of the change in status. An example letter . In healthcare, non-solicitation restrictions can extend to patients and other providers who refer patients to the practice or business. This can be significant, especially if you deliver babies. The settlement arose from events in the spring of 2015. 7. 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). https://www.msma.org/guide-to-closing-a-medical-practice.html. By contrast, a non-solicitation provision prohibits the employee from soliciting the employers clients and personnel for other business or work opportunities. Copyright 2023 American Academy of Family Physicians. There is no specific time period required. 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. Which patients should be notified? Yes. 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. For example, practices often agree to pay for tail coverage in the event that employment is terminated by the practice without cause. 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. Notify the regulatory and business agencies impacted by your closure, including Centers for Medicare & Medicaid Services (CMS), Drug Enforcement Administration (DEA), health insurers, state medical or business associations, and state medical boards. 115(4): 325327 advises, practices must notify patients as soon as possible to facilitate continued patient care. Accessed January 18, 2023. 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. Notifying Patients of Physician Leaving Practice In all the steps we discussed above, you may have noticed that informing your patients about your departure is crucial. In contrast, patient abandonment is more prone to arise from the failure to properly act. Having undertaken the care of a patient, the physician may not neglect the patient. The physician must notify the TMB and his/her patients, and advise who has custodianship of the medical records and how a copy may be obtained. 3. At our healthcare law firm, our clients frequently voice concerns over the non-solicitation provision in their employment agreements. Sources Hear from top leaders in medicine 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. Determine whether solicitation of employees is prohibited. 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. They worry that it will force them to abandon their established patients in violation of their legal and ethical obligations. 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. 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. 1, 2. (i) Sending a letter to each patient; OR In healthcare, this tug of war can implicate another stakeholder: the patient. 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. Is a list of patient names without information about the patients medical condition considered PHI? As we were assembling the resources for this document, we were amazed at the level of vague, incomplete, and even inaccurate material on the internet regarding notification requirements for closing medical practices. The Texas Medical Board (TMB), in an attempt to address this issue, adopted regulations that must be followed whenever a physician leaves a group. 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. What should be in the notice? It is not just a piece of advice; several state and federal regulations make it a mandate. Leaving Group Practice - hcms.org You and the practice have an obligation to provide proper care for your patients. Weve compiled a resource to compare guidelines for every US state. For instance, providers who staff emergency departments, hospitalist programs, and urgent care centers render care that is episodic in nature. Section 5-5: If a licensee ceases to engage in practice: Publish a notice and the established procedure for the obtaining of records in a newspaper of general circulation at least once a month for the first three months after the practice closes and forward a copy to the Board. A number of patients called the Medical Center and complained about the letter they received. (I) Posting such notice on the physician's or practice website; OR TMB rules for physicians who retire, close, or leave a practice - TMLT Why? All patients of record who have not requested their records 30 days before the person discontinues the medical-practice business or leaves the State must be notified by first class mail by the person to permit that persons patients to procure their records., http://delcode.delaware.gov/title24/c017/sc05/index.html, Florida Statute Title 32 Ch. 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. 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. When possible, the outgoing provider should try to time their exit so that patients can arrange continuity in care. 1) The state has enacted law regarding patient notification. No. In March 2015, the NP was preparing to leave URMC for a position at Greater Rochester Neurology (GRN). Florida Non-compete Law: No Direct Solicitation When a Patient The analysis will always depend on the particular circumstances involved. 1997) supports this understanding. Don't worry, I did that on purpose. Texas Medical Board. 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). The office should also consider changing its answering message to alert patients 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.