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. In healthcare, this tug of war can implicate another stakeholder: the patient. 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 . If possible, consider posting your retirement in your local newspaper(s) as well as on your website and/or social media pages (if applicable). 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. This letter must be sent by certified mail, return receipt requested. PDF The Doctor is Out 1) The state has enacted law regarding patient notification. For example, you would never want to be in a situation where you felt compelled to lie to a patient. Please contact [emailprotected]. The legal guidelines regarding patient notification vary for each state. 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. 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). 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. Before you make any decisions, revisit your employment contract and your states laws regarding the issue. Rarely do practices agree that patient charts are the property of the employed physician. Approximately ninety days is suggested whenever possible. If you would like to learn how Lexology can drive your content marketing strategy forward, please email [emailprotected]. 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. 4. Review advance notice provisions. Anyone looking for information on this topic should be aware of the risk in assuming a simple internet search will provide clear and accurate information. https://docs.legis.wisconsin.gov/code/admin_code/med/10/03/3/j. Generally, tail coverage costs between 1.5 and two times a physicians annual premium. 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. A physician shall ensure that emergency medical care is available to the patient during the 30-day period following notice of the termination of the physician-patient relationship., https://www.legis.iowa.gov/docs/iac/rule/09-22-2010.653.13.7.pdf, Kansas Board of Healing Arts (a regulatory board created by legislature for the purpose of education, administration, regulation enforcement) advises providers follow AMA Guidelines. The sign or notice shall advise the physicians patients of their opportunity and right to transfer or receive copies of their records. Health care entities must be prepared for the departure of physicians and other health care professionals. In addition to reviewing any documents you have signed, you should review any of the practices policies applicable to employment and departures. The FMA also . Likewise, physicians often agree to pay for tail coverage if they terminate their employment without cause. Web Design Trundlemedia, Health Insurance Portability and Accountability Act(HIPAA). Physician Anti-Solicitation Clauses: A Case Study - Law360 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). Many physicians believe these covenants will not be enforced; however, the courts in most states will uphold them if they are reasonable. By contrast, a non-solicitation provision prohibits the employee from soliciting the employers clients and personnel for other business or work opportunities. 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. 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. When scheduling your departure from the practice, take reasonable steps to ensure that you are not leaving any patients in a bind. Though every clients situation is unique, a good place to start when planning for your practices records after retirement or closure is reviewing the legal guidelines for your state regarding patient notification. 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. The cost of successfully defending a medical malpractice action is lifestyle altering. 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. TMB rules for physicians who retire, close, or leave a practice - TMLT 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. 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. 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. Or, in limited circumstances, the new practice may provide coverage through a new policy with a retroactive endorsement date. How does the estate of a deceased or incapacitated physician provide 30-day notice? Copyright 1997-2023 TMLT. Further, many deferred-compensation arrangements are linked to the amount of notice given. The answer is yes. Non-solicitation clauses are a type of restrictive covenant (meaning legally that they forbid a party from doing something). This will most likely include an employment agreement, a shareholders agreement (if the practice is a corporation) or an operating agreement (if the practice is a limited liability company) and, in some cases, a deferred compensation arrangement. 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. Sources Closing or leaving a practice: Tips for primary care physicians 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. 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. The health care entity has the dual role of safeguarding the medical record while facilitating continuity of care. University of Florida Levin College of Law UF Law Scholarship Repository 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. Harris County Medical Society. Can Physician Assistants Own Independent Medical Practices? Say, for example, a provider leaves a dermatology practice to join a medical spa that performs cosmetic procedures not available at the dermatology practice. 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. 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. 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. For instance, general advertisements, mailings to certain zip codes, and routine marketing activities normally would not meet this standard. Physicians are generally required to notify patients directly through one or more channels . She can be reached at laura-brockway@tmlt.org. The KBHA serves as a great resource to physicians. 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. But it is highly recommend for the protection of the physician and the patient. http://164.64.110.134/parts/title16/16.010.0017.html, Additional Resources: The New Mexico Medical Society offers, Closing Your Practice Guide: In fact, you must notify them- you can't just leave and let them find out you're no longer their provider. Each state treats notification guidance differently, but their approach generally falls within four distinct categories. 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. A non-solicitation clause only prohibits solicitation. It is imperative patients are notified well in advance of closure to ensure they have access to their medical records for continuation of care. https://www.leg.state.nv.us/nrs/nrs-630.html#NRS630Sec304, NH Rev Stat 329:9 Section: Med 501.02 Standards of Conduct. The physician fails to allow for patient access to or transfer of the patients health record as required by law. 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. A Must-Do List for the Departing Physician | AAFP A critical criterion for patient abandonment claims is the need for further treatment. 2. The NP was interviewed, suspended, and subsequently terminated. A clean departure will save you headaches and possibly dollars in the immediate future and in the long run. 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. They worry that it will force them to abandon their established patients in violation of their legal and ethical obligations. 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. A threshold requirement for a malpractice claim premised on patient abandonment is that there is a patient-provider relationship. 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. From tail coverage to giving notice, heres how to prepare yourself, your partners and your patients for your departure. While the Board rule does not specify the mode of notification, it would be difficult to ensure patients received notification by a newspaper ad. TMB rules for physicians who retire, close, or leave a practice. 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.