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. 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. Understand who owns the chart. A copy of this notice shall also be submitted to the Board not less than one (1) month prior to the date of termination, sale, or relocation of the practice. 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. 3. Keep a step ahead of your key competitors and benchmark against them. The next generation search tool for finding the right lawyer for you. It also informed URMCs workforce of its policy that information regarding continuity of care was to be communicated to patients by URMC, not the individual health care providers. 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. Therefore, patients should be given reasonable advance notice to allow their securing other care. 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. The scope of practice of CNAs, as well as other nursing professions (RN, APRN, etc.) 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. There is no specific time period required. Dont risk falling short on your notification message which can result in charges of abandonment. Some states even require or suggest 30 days prior written notice before a departure so that. 4. Review advance notice provisions. She can be reached at laura-brockway@tmlt.org. The sign or notice shall advise the physicians patients of their opportunity and right to transfer or receive copies of their records. The answer is yes. Many practices obtain claims made malpractice insurance policies that insure you for claims made during your term of employment. This creates a quandary because although you may need new employees, you do not want to appear to be soliciting from the existing practice. 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. Indeed, this may be especially appropriate when the employment agreement defines patients treated by the employee as the employers. Do not be seduced into foregoing the purchase of tail coverage. (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. Each patient should receive a letter and notices should appear in local newspapers at least three times over a few months or more. Rarely do practices agree that patient charts are the property of the employed physician. At our healthcare law firm, our clients frequently voice concerns over the non-solicitation provision in their employment agreements. Likewise, physicians often agree to pay for tail coverage if they terminate their employment without cause. 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. 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. 2. A letter placed in the patients monthly billing notice is one method. Health care entities must be prepared for the departure of physicians and other health care professionals. Unless your employment agreement provides otherwise, you may be able to notify patients that you are leaving the practice . 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. It is, however, not uncommon for employees to solicit the departing physician prior to departure. Ultimately, a patient always has the right to seek out a provider of their choosing. Mind These Legal Issues. Employment contracts usually reinforce this notion. 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. Does a heath care practitioner have to accept new patients? 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. Weve compiled a resource to compare guidelines for every US state. 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. However, the information provided does not, and is not intended to, constitute legal advice; instead, all information, content, and materials available on this site are for informational purposes only. If you would like to learn how Lexology can drive your content marketing strategy forward, please email [emailprotected]. Unprofessional conduct includes, but is not limited to, the following: (17) Abandoning a patient. Alert your state medical board in case patients contact them for information. All Rights Reserved. In these cases, patients do not expect the same provider to perform related services in the future. URMC began receiving calls from patients who were upset that their confidential medical information had been disclosed without their permission. 3) The state offers no guidance, but another state association (i.e. These functions included taking phone calls from existing patients with treatment-related questions. This can be significant, especially if you deliver babies. 8. During your review, pay careful attention to information about advance notice provisions, retirement plan details and noncompete covenants, to name a few key elements. What if a given non-solicitation provision does not restrict a providers right to notify patients of his or her departure? 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. (ii) Publishing a notice 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 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. It is imperative patients are notified well in advance of closure to ensure they have access to their medical records for continuation of care. 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. 1, 2. 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. 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. The notice shall appear twice, seven days apart. All returned mail should be kept in patient file. Generally, tail coverage costs between 1.5 and two times a physicians annual premium. However, it at least informs the patients that the provider is not responsible for their further care. Having undertaken the care of a patient, the physician may not neglect the patient. The physician may, but is not required to, place a sign in a conspicuous location on the faade of the physicians office or notify patients by letter, of the termination, sale or relocation of the practice. By contrast, a non-solicitation provision prohibits the employee from soliciting the employers clients and personnel for other business or work opportunities. The FMA also . In our experience at Jackson LLP, rarely are any two non-solicitation clauses alike. The employer pulls in one direction, seeking to draft the non-solicitation clause broadly to protect against internal poaching of clients and staff. These rule changes also apply when leaving a group practice, as the departing physician is responsible for providing proper notification. 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. Notification may be satisfied using any of the following methods: (1) by placing a notice in at least one newspaper in the local practice area; notice should advise patients where their medical records will be stored; notice should include any pertinent information the patient may need for obtaining or transferring the records, including the name, mailing address and telephone number of a contact person with access to the stored records; notification should run a minimum of two times per month for three months to reach a maximum number of patients; or (2) by written or electronic mail; or (3) by individual correspondence to the patients last known physical or electronic mail address. According to the urologists former employer, such activities violated the non-compete. 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. The first example letter for notifying patients of a physician leaving their practice comes from Medical Center Clinic. From tail coverage to giving notice, heres how to prepare yourself, your partners and your patients for your departure. These policies and others are discussed separately below. For assistance, members of The Doctors Company can contact a patient safety risk manager at (800) 421-2368 or by email. Determine whether solicitation of employees is prohibited. A 24-year-old pregnant woman came to her ob-gyn with a headache and high blood pressure. Voice mail systems can also be modified to provide new contact information after the physician has departed. The office should notify patients as soon as possible to support continuity of care for the deceased physicians patients.2 As a first priority, the office staff should call patients with scheduled appointments so patients with immediate needs for a physician can find another healthcare provider. Thus, regardless of who is responsible for procuring tail coverage, that party should provide a certificate of insurance to the other party. 10. Review noncompetition covenants. 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). Common questions include: Navigating the line between non-solicitation and patient abandonment poses a challenge. The notice should be in the form of a letter sent to the patient, preferably certified with a return receipt requested. 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. Ensure that their records can be transferred to another health care provider as requested by the patient, and c. Whenever possible, notice shall be provided at least 30 days prior to cessation of treatment; and (10) After transfer of the licensees medical records which meets the requirements of (9) above, the licensee shall be relieved of further responsibility for complying with requests for copies of records., http://www.gencourt.state.nh.us/rules/state_agencies/med100-600.html, State advises in Section 1-15, The doctor must notify the patient, in writing, that he/she will no longer provide care as a date certain, which cannot be less than thirty days prior to the termination date. 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. Become your target audiences go-to resource for todays hottest topics. 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. A notice in an email in a manner compliant with state . Confidentiality clauses usually define patient information and records generated during the providers employment as the practices property. URMC responded by sending breach notification letters to the affected patients and notifying the media. 1 Required notification of discontinuation of practice Why? . 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. In fact, you must notify them- you can't just leave and let them find out you're no longer their provider. 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. 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 notice may be given by publication in a newspaper of general circulation in the area in which the health care facility is located. We can help you assess your rights and responsibilities. It is critical that you understand what you have promised to do and what has been promised to you via these documents. An example letter . Under Florida law, when a licensed physician terminates practice, or relocates and is no longer available to patients, the physician must publicly announce their withdrawal from practice by publishing an announcement once a week, for four consecutive weeks. is regulated by the Florida Board of Nursing. Consider patient needs. Contact information for providers remaining in practice, Necessary information regarding access to medication, How medical records will be stored and how they may be accessed, Contact information for the records custodian, Expected timeline for transitioning the records, Date records will become available and how long they will be available for request. Med 10.03.2 (o) states, Patient abandonment occurs when a physician without reasonable justification unilaterally withdraws from a physician-patient relationship by discontinuing a patients treatment regimen when further treatment is medically indicated and any of the following occur: 1. 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 Florida Medical Association is not affiliated with the Board of Medicine. Its an important aspect of [], At Cariend, we understand the challenges faced by healthcare facilities in transition. (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. The health care entity has the dual role of safeguarding the medical record while facilitating continuity of care. In this way, the provider might avoid claims of patient abandonment. (i) Sending a letter to each patient; OR 2. Review the practices established policies. It is not just a piece of advice; several state and federal regulations make it a mandate. The physician fails to give the patient at least 30 days notice in advance of the date on which the physicians withdrawal becomes effective. Which patients should be notified? What is the health care entitys responsibility when a physician departs? 2. Say, for example, a provider leaves a dermatology practice to join a medical spa that performs cosmetic procedures not available at the dermatology practice. Can Physician Assistants Own Independent Medical Practices? 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 clean departure will save you headaches and possibly dollars in the immediate future and in the long run. A threshold requirement for a malpractice claim premised on patient abandonment is that there is a patient-provider relationship. Itshould not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction. Negotiations over non-solicitation restrictions can play out like a game of tug of war. This should be posted in your office well in advance of your official retirement. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. 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. https://docs.legis.wisconsin.gov/code/admin_code/med/10/03/3/j. Laura Hale Brockway is the Vice President of Marketing at TMLT. 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. The California Medical Board ("CMA") advises that patients should be notified of changes in the medical practice and recommends "that due care should be exercised when closing or departing from a medical practice." Post the notification on the practice website. Clearly, a provider is not susceptible to an allegation of patient abandonment each time arelationship with a patient terminates. 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. 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. 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. This letter must be sent by certified mail, return receipt requested. All rights reserved, Prohibition Against Interference 165.5(c)(1-2). It is important to be mindful when reviewing sample closure letters floating around on the internet that most fail to consider many items beyond closure date and how to obtain copies of medical records. 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. Can I take a copy of my patients records with me, in case they need care from me in the future. 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. 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 . 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 . For example, you would never want to be in a situation where you felt compelled to lie to a patient. 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. is an individual issued a license allowing them to practice medicine. Yes. Although the Health Information Portability and Accountability Act of 1996 (HIPAA) prohibits the unauthorized disclosure of PHI, the NP disclosed the PHI to her new employer, GRN, without the patients authorization. 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. Notify patients in writing, through a letter carefully crafted with input from practice colleagues or the employing . Notice to Patients. A Coda to the Covid Pandemic: Do Local and State Closure Laws Provide Cover for Tenant Nonpayment of Rent? Not only does this ensure a smooth transition from the current physician to the new treating physician, but it also reduces the liability of patient abandonment. Therefore, to ensure this occurs with a minimum of disruption in continuity of care, the physician terminating the physician-patient relationship should notify patients sufficiently in advance., https://www.mbc.ca.gov/Licensees/Close_Practice.aspx. 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. But it is highly recommend for the protection of the physician and the patient. Perhaps youre already a party to a non-solicitation agreement, and youre wondering how it will affect your future opportunities. 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. (B) Placing written notice in the physician's office; AND A physician shall provide a patient written notice of the termination of the physician-patient relationship. You should review the details of your plan so that you do not unwittingly forfeit significant amounts of retirement money. Be aware that patient lists, patient charts and other patient demographic information are property of the practice, not the departing physician. (2). The agreement provided that for 12 months following termination of employment, the urologist would not engage in the practice of medicine within a 50-mile radius of the employer. All rights reserved. 1. If you are asking your partner to leave, you need to know the practices rights and obligations to him or her. 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. First, ensure proper notice is provided to patients as well as all interested governmental entities and other organizations. A physician must give notice to patients of his or her leaving or closing a practice, otherwise face a possible claim of patient abandonment. Abandonment occurs when a physician withdraws his services after a physician-patient relationship has been established, by failing to give notice to the patient of the physicians intention to withdraw in sufficient time to allow the patient to obtain necessary medical care.