When Would My Healthcare Practice Use a Promissory Note? Notify Third Parties Dependent upon the provisions of contracts and state law, the insured physician and practice may need to notify various third parties. In our experience at Jackson LLP, rarely are any two non-solicitation clauses alike. This content is owned by the AAFP. 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. 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. 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. Who should provide the notice? 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. 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. 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. Can a health care practitioner terminate a patient relationship? Closing or leaving a practice: Tips for primary care physicians 2. If you are responsible for tail coverage, you may be able to negotiate with your new practice to provide you with sufficient funds to purchase it. 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: An example letter . Make sure that if there are legal guidelines in you state, that you review them. 2. Review the practices established policies. This may vary from practice to practice. A non-solicitation provision is usually triggered only by an action. University of Florida Levin College of Law UF Law Scholarship Repository Through our years of experience in the custodial records field, we have worked with clients in almost every health care arena and handled the full spectrum of records management needs. A health care practitioner can terminate a patient relationship at any time, but the practitioner may not abandon a patient and should provide continuity of care in accordance with the prevailing professional standard of care. The statute adopts the concept of a "records owner." A "records owner" may or may not be a physician. 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. With respect to patients, solicitation generally requires a targeted, affirmative act by the employee to convince a patient to obtain services from somewhere other than the employers practice. 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). What if a given non-solicitation provision does not restrict a providers right to notify patients of his or her departure? 10. Review noncompetition covenants. OB/GYN Physician - Brand New Offices with Well-Established Group Practice 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. Often practices and departing physicians will agree on what to tell patients who inquire about the tenure of the departing physician. Normal workplace stresses are exacerbated by longer hours, less pay and zero tolerance for error, which can lead to fractured relationships among partners or employed physicians in a group practice. Itshould not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction. PDF The Doctor is Out Is a list of patient names without information about the patients medical condition considered PHI? Yes. The notice shall appear twice, seven days apart. Likewise, physicians often agree to pay for tail coverage if they terminate their employment without cause. This creates a quandary because although you may need new employees, you do not want to appear to be soliciting from the existing practice. Become your target audiences go-to resource for todays hottest topics. Post the notification on the practice website. 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. Florida Non-compete Law: No Direct Solicitation When a Patient The answer is yes. 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. They are often related to, but distinct from, non-competition clauses, or non-competesanother type of restrictive covenant common in employment agreements. As the above discussion shows, solicitation and patient abandonment claims are not limitless. As these examples show, non-solicitation does not mean no contact. The notice must include an explanation of how copies of the facilitys records may be accessed by patients. 1. Review all documents you have signed. 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 . Thus, their specialty naturally limits their exposure to allegations of patient abandonment when they leave their jobs. Physicians are generally required to notify patients directly through one or more channels . Prohibition Against Interference 165.5(c)(1-2)rules state that: If youre in one of the states where we practice, schedule a complimentary phone consultation with one of Jackson LLPs healthcare attorneys. How to text patients and colleagues without violating the Health Insurance Portability and Accountability Act. 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. Drafting the Notification Letter . A letter placed in the patients monthly billing notice is one method. 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. Approximately sixty days prior to closure, patients who require frequent follow up should be referred to other physicians and patients with acute medical problems should have appropriate follow up arranged., https://www.maine.gov/md/sites/maine.gov.md/files/inline-files/2017summer_0.pdf, State advises, adequate time must be given to allow the patient to obtain a new practitioner. 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. 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.. Some states dont specifically list steps for closing a practice, but simply note the requirements for terminating a physicians relationship to patients. 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. 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. There may also be different rules for different types of medical facilities or practice types, such as hospital vs. private practice, or psychiatry vs. dentistry. 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. Jennifer Bendokas, PA-C | White-Wilson Medical Center | Fort Walton Rarely do practices agree that patient charts are the property of the employed physician. Connecticut Code of Medical Records Regulations Number 19a-14-44 states, Upon the death or retirement of a practitioner, it shall be the responsibility of the practitioner or surviving responsible relative or executor to inform patients. Generally, tail coverage costs between 1.5 and two times a physicians annual premium. What should a hospital or medical group do now? The notice to patients should be a minimum of 30 days. Non-Solicitation and Confidentiality Clauses. 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. Or, in limited circumstances, the new practice may provide coverage through a new policy with a retroactive endorsement date. In Illinois, as in many other states, patient abandonment is not only a form of malpractice; for physicians, it is also grounds for disciplinary action against ones license. PDF Notice to Patients on the Departure of a Physician 1, 2. The notification letter should be professional and nonconfrontational, and it should set a tone that aims to maintain the best possible relationship with the patient. Keep a copy of the notification letter in the patient's record. The settlement arose from events in the spring of 2015. (Abandonment is defines as the termination of the physician patients relationship at an unreasonable time and without giving the patients the chance to find an appropriate replacement.) 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. Determine whether solicitation of employees is prohibited. The health care entity has the dual role of safeguarding the medical record while facilitating continuity of care. This comparative map shows the patient notification guidelines for all 50 states. 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. URMC responded by sending breach notification letters to the affected patients and notifying the media. According toSchneiderman, Other medical centers, hospitals, health care providers, and health care entities should view this settlement asa warning, and take the time now to review and amend, asneeded, their own policies and procedures to better protect private patient information.. 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. Understand your clients strategies and the most pressing issues they are facing. The FMA also . Each state treats notification guidance differently, but their approach generally falls within four distinct categories. P&S Practice Information | MBC - California The notice shall provide the patient with 30 days to request a copy of his or her record or to designate where he or she would like his or her medical records transferred and shall request from the patient within 30 days written authorization for the destruction of his or her medical records., http://www.legislature.mi.gov/(S(qm1p2yrrhuxenh2d4yfgk1dd))/mileg.aspx?page=GetObject&objectname=mcl-333-16213, Mississippi State Board of Medical Licensure Policy 3.17 advises, whether by relocation, retirement, disability or death, the patient should be advised of the right to have the medical records sent to the physician of their choice. TMB rules for physicians who retire, close, or leave a practice - TMLT 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 rule changes also apply when leaving a group practice, as the departing physician is responsible for providing proper notification. Employment contracts usually reinforce this notion. 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. Copyright 2006 - 2023 Law Business Research. Weve compiled a resource to compare guidelines for every US state. Accessed January 18, 2023. See the bottom of this page for a state-by-state comparison of the available guidelines. Are you a healthcare provider considering a new employment agreement with a non-solicitation clause? In contrast, patient abandonment is more prone to arise from the failure to properly act. https://www.leg.state.nv.us/nrs/nrs-630.html#NRS630Sec304, NH Rev Stat 329:9 Section: Med 501.02 Standards of Conduct. (ii) Sending an email to each patient, in a manner that is compliant with state and federal law. Placing a sign on the door of the closed practice only works if the space will not have future tenants. If possible, consider posting your retirement in your local newspaper(s) as well as on your website and/or social media pages (if applicable). In this situation, the provider might not be precluded from soliciting that practices patients for services at the medical spa. 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 . By contrast, a non-solicitation provision prohibits the employee from soliciting the employers clients and personnel for other business or work opportunities. Section 456.057, Florida Statutes, sets forth the requirements that must be followed when a physician retires, closes his office or relocates his practice. 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. If the practice has social media, post the notification message there as well. the state Medical Association or Board) has guidelines available. [], 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. 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. 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. All Rights Reserved. It may also resolve the issue in advance by including a provision in the physicians written employment or other affiliation agreement that specifies the details of the notice that the health care entity will send in the event of the physicians departure. leaving a practice Within 90 days after a death . The health care entity, which is the party responsible for maintaining custody of the medical record, should send the notice. Its an important aspect of [], At Cariend, we understand the challenges faced by healthcare facilities in transition. 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. Further, many retirement plans have vesting schedules that depend on the number of years one has worked with the employer. The health care entity has the dual role of safeguarding the medical record while facilitating continuity of care. The answer is yes. The physician fails to give the patient at least 30 days notice in advance of the date on which the physicians withdrawal becomes effective. A threshold requirement for a malpractice claim premised on patient abandonment is that there is a patient-provider relationship. 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. Doing so could subject the provider to claims of abandonment by the patient. 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. What can I tell my patients when Im leaving my employer? Such an approach may frustrate the provider who is leaving. 1, Required notification of discontinuation of 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. Copyright 1997-2023 TMLT. Readers should consult their healthcare attorney to obtain advice with respect to any legal matter. Starting, Closing, or Selling a Practice | AAFP For assistance, members of The Doctors Company can contact a patient safety risk manager at (800) 421-2368 or by email. 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. Yes. https://www.njconsumeraffairs.gov/bme/Pages/FAQ.aspx, NMAC 16.10.17.9 states, Whenever possible, active patients and patients seen within the previous three years must be notified at least 30 days before closing, selling, relocating or leaving a practice.