With medical reimbursements under siege and the cost of maintaining a medical practice increasing, it’s inevitable that providers will continue to consolidate or be forced to close their practice. For medical imaging businesses, the additional pressure from the large capital expenditures required, is causing more practices to head for the exit. For firms considering closure, there are a host of legal and business concerns.
The closure process is much more complicated than just closing your doors. We’ve outlined important considerations that can help you navigate through the process.
Notify regulatory bodies
While the FDA does not prescribe a specific notification for closing of a practice, it is highly recommended that you provide the FDA with the basic information on how your patients will be notified and will be able to obtain their records. If you do breast imaging, you also are responsible for abiding by MQSA guidelines which provides additional guidance on closing a facility.
You also must notify your state radiation control program as well as your specialty accreditation body.
Providing your patients with advance notification is good practice. You need to make a reasonable attempt to inform your former patients of how they can get their records. But a reasonable attempt is open for interpretation. Generally, this means notifying all current patients (for the past two or three years) and any patient who is undergoing active treatment.
There is no specific timing for how much advance notification you are required to provide. But certainly ensuring that patients who show up for scheduled appointments don’t find a locked door will help to prevent potential aggravation. Sixty day notice in advance of closing your practice seems to be a good rule of thumb. In your notification, let your patients know alternative locations for their future treatment and how they can obtain copies of their records. It’s also a good idea to put a notice on your door, notify referring physicians, and post a notice in your local newspaper.
There are a host of overlapping regulations for how long you must retain patient records. As a general rule, retaining patient files for at least seven years, as CMS requires, is advisable. HIPAA regulations seem to indicate six years is sufficient, but your particular state laws may differ. For patients who are minors, the general rule is that all records should be kept for 28 years from their birth.
Making records available to patients
You are required to make patient records available directly to patients and/or their authorized new providers, post closing,. Be sure to maintain your patients’ privacy by not releasing records without proper authorization. Creating a method to authenticate their identity remotely (over the phone or web) is usually the best practice. You can usually accomplish this your patient notice correspondence.
Custodian of patient records
Either you or another organization that you designate will need to be available to provide patients with their records for an ongoing period of time – coinciding with your required records retention duration. Assuming you don’t want to keep an alphabetized stash of duplicate CDs in your basement, hiring a records retention custodian is a good practice. Be sure you have them sign a BAA and that they are bound to abide by privacy practices for your patients. Your custodian should be able to make these patient records available for a prescribed (by contract) period of time to ensure your compliance.
Duplicate patient records
You never want to hand over the only copy you have of your patients’ records. Be sure that you keep a copy (electronic is obviously easier) of all of your patient records should you need them in the future. Be sure that your custodian retains a copy of whatever they share with your former patients.
Charging for patient records
Most states permit you to charge your patients for creating duplicates of their records. Generally, these state regulations allow you to charge a reasonable amount that corresponds roughly to the cost of generating these record copies. Some states are more specific about what you can charge.
Closing your practice and need help extending medical records to patients?
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*Purview is an experienced records custodian and can establish a process to ensure your patients get continued access to their records post closing. This article is not intended to provide legal advice. We suggest that you always consult with your particular state’s regulations and competent legal counsel before taking action.