Closing a practice involves more than closing the door. Indiana’s Discontinuance of Practice Rule provides definitive guidelines in such cases, especially regarding your patients and their health records.
Notice to patients
An early step in closing your practice is notifying your patients. Notification rules require that you send a letter to all patients you have treated in the last two years (active patients), or that you post a notice in the local newspaper once a week for three consecutive weeks.
“Patients rarely see the newspaper notice,” said Julie Reed, J.D., ISMA’s general counsel. “The better job you do of notifying patients in advance and providing them detailed information about how they can obtain copies of their health records, the more smoothly the process will go and the less likely patients will be to file complaints. In the end, the goal is to ensure patient continuity of care.”
ProAssurance Indemnity Company, the ISMA's endorsed malpractice carrier, recommends you notify patients in writing 60 to 90 days in advance to avoid potential abandonment claims.
If you are leaving or retiring from a group practice, ProAssurance advises that you inform patients they can switch to another physician in the same group. If you are retiring as a solo physician, let your patients know if another physician will be assuming the practice, otherwise encourage them to find a new physician.
Contracts you have signed with health insurance companies may also address notification obligations – to them or to their insureds.
What to do with health records
By law, you must maintain health records for at least seven years from the last treatment date, even if you are retiring. Since there is no state repository for medical records, consider one of the following options:
- Convert records to electronic format and store on a secured hard drive or disk
- Transfer them to another physician or hospital
- Store records at your residence
- Hold records in a document storage facility
“Patients are still entitled to copies of their records,” Reed noted. “So, you need to store them where they will be accessible but safe, secure and confidential by HIPAA standards. If a third party will be assisting you with the storage and retrieval, you will probably need a HIPAA Business Associate Agreement, too.”
Need more details? Call the ISMA Legal Department for a packet about closing a practice at (317) 261-2060 or (800) 257-4762.