Insurance InsIghts 24 Medicine in Oregon Oregon www.TheOMA.org Risk management solutions from CNA Healthcare whether leAvinG A SOlO or group practice, every physician must provide patients with a safe, smooth transition of medical care. This article examines some of the key issues—such as patient notification, record management, practice closure or succession planning, licensure and insurance coverage—that arise when shifting from full-time practice to retired or part-time status. Notification requirements By giving notice of retirement in a timely manner, physicians promote continuity of patient care, reduce the risk of abandonment allegations, and fulfill contractual and regulatory obligations to the following bodies, among others: Œ Hospitals and group practices. Œ State licensing boards and other credentialing organizations. Œ National, state and local medical societies and associations. Œ The Drug Enforcement Administration (DEA). Œ The Centers for Medicare and Medicaid Services. Œ Liability insurance carriers. It is a good practice to consult with a legal advisor early in the planning process regarding compliance with service contracts and regulatory requirements. At least three months prior to the planned practice closing or departure date, notify active patients of the fact in writing via first-class mail. The announcement should include the following information, at a minimum: Œ When the last day of practice will occur. Œ Whether a final appointment is indicated or scheduled. Œ How to obtain a copy of medical records. Œ How to request transfer of records to another physician. Œ Who will be taking over the practice, if anyone. Œ How to contact a physician referral service and/or nearby practitioners who are accepting new patients. Place a copy of the notification letter in each patient’s medical record. (See the sample announcement letter at http://www. theoma.org/closing-your-practice-sample-letterpatients.) Specialty physicians also should post an announcement in local newspapers or on health care-oriented websites for the benefit of referring physicians and occasional patients. Patients with a chronic or higher-risk medical condition should be informed of the retirement or practice closing in person or by telephone, with the discussion documented in the patient’s healthcare information record. Send a follow-up letter to summarize the discussion content, as well as to remind the patient of referrals already made and reiterate the need to promptly select another physician. A regular or registered letter may be sent in lieu of a telephone call. Record maintenance Unless an employment agreement provides otherwise, patient healthcare information records are typically owned by the medical practice. When a practice is sold upon retirement, the buyer generally becomes the owner of the records per contractual provision. For this reason, the contract should contain a clause allowing the seller to access medical records in the event of a lawsuit. If a patient elects to leave the practice following a provider’s retirement, a copy of the complete chart may be sent to the new physician with the patient’s signed authorization. However, the original chart must be maintained for at least the statutory minimum period. (The Oregon Medical Association offers guidance on medical record maintenance and retention, as well as other retirement- and relocationrelated topics, at http://www.theoma. org/closing-your-practice-oma-medical-legalinformation.) If records are to be stored off-site, execute a written contract with the storage firm, outlining the obligations of both parties. If the time comes to purge paperbased patient files, retain an established document-shredding firm. Practice closure or sale When closing or selling a practice upon retirement, the following measures are recommended: Œ Notify staff three months in advance of the anticipated closing date, informing them about severance policy and benefits arrangements, if applicable. Œ Fulfill legal and financial obligations pertaining to employees’ retirement plans, health insurance coverage, and unused vacation and sick days. Œ Contact one’s professional liability insurance company to determine the desirability of obtaining “tail coverage” (i.e., an extended reporting period for claims filed after the policy has expired). Œ Destroy paper prescription pads and letterhead after the last appointment and delete electronic templates. Œ Discard controlled drugs in accordance with DEA procedures, and return any DEA license to the agency. Physician Retirement Preparing for a Smooth Transition
OMA Spring 2015 Magazine
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