Closing a Medical Practice, Part 2

As discussed in part 1 of this post, closing a medical practice can be burdensome and complicated. In the first segment, notification to the licensure board, patients, employees, and DEA was discussed. Some other smaller steps a physician should consider taking to ensure a clean closure include:

• notifying the practice’s accountant;
• notifying the office/property insurer;
• collecting all past-due billing from patients and insurance companies;
• if the office space is leased, ensuring that have taken the proper steps with the landlord to discontinue the lease;
• planning the sale of the medical practice if the practice is a partnership with other physicians and check to see if there is a “buy and sell” agreement in place;
• ensuring all final payments and credits are settled with suppliers;
• notify all utility companies;
• if retiring, notifying all professional associations, such as the American Medical Association (AMA) and the Medical Association of Georgia (MAG);
• Changing the mailing address and canceling any subscriptions.

Medical Records. Beyond these smaller, more tedious steps, the most involved part of closing a medical practice is ensuring proper handling of patient’s medical records. Georgia physicians are required to maintain a patient’s complete treatment records for at least 10 years from the date of the patient’s last office visit. These requirements do not apply to a physician who has retired or sold his or her medical practice if:

1. the physician has notified his or her active patients of their retirement or the sale of their practice by mail, offering to provide the patient’s records to another provider of the patient’s choice and, if requested, to the patient.
2. the physician has published a notice that contains the date of retirement or sale that offers to provide the patient’s records to another provider of the patient’s choice and, if requested, to the patient.
3. the physician has posted a sign announcing their retirement or the sale of their practice. The sign must be posted 30 days prior to retirement or sale of the practice and must remain posted until the date of retirement or sale.
4. the physician has placed both the notice and sign required by Rule 360-3-.02(16)(c) and that they have advised their patients of their opportunity to transfer or receive their records. (please see Georgia Rules and Regulations: Unprofessional Conduct Defined 360-3-.02)

A physician who is retiring or closing a practice must notify all active patients and allow them adequate time to retrieve their records. The physician also needs to post a public notification. Under Georgia law, the physician has no duty to retain medical records for the ten years required by statute if the above listed steps have been taken. However, private attorneys and medical liability insurers often advise physicians to retain records for at least five more years – this is the maximum amount of time a patient could file suit against a physician under the statute of repose. If the physician chooses to maintain their records, storage facilities exist with whom a physician can store their patients’ medical records within HIPAA regulations.

If a physician is leaving a practice to practice elsewhere in state, that physician needs to notify all patients that they are leaving the practice and examine any hospital bylaws or employee contracts very carefully. In Georgia, the law does not specify whether patient records belong to the treating physician or the medical practice as a whole. The law only states that they belong to the provider, which is defined broadly to include physicians and medical practices. If the physician and practice cannot come to an agreement, the physician should seek advice from a private attorney.

Business Records. Some business records must be maintained for varying lengths of time after closing a practice. A physician should consider consulting an attorney to help determine how long certain records should be maintained. Business records include, but are not limited to: payroll records, personnel files, accounts payable invoices and credits, contracts, shipping and billing records, earning records, and OSHA records. The HIPAA privacy regulations require you to retain HIPAA documentation (e.g., acknowledgment of receipt of privacy notice, requests for amendments, workforce training documentation) for a period of at least six years.

Contact Professional Liability Carrier. Finally, a physician must contact their professional liability insurer to determine what coverage they can cancel and what coverage is still necessary. Even after retirement, a physician may still be sued for malpractice arising from treatment rendered while still in practice. Tail coverage may be recommend by the insurer to cover all remaining liability. It is also important to discuss medical record retention with the liability insurer, as they may have their own requirements for the physicians they insure.

A physician should always seek legal counsel if they are struggling to close or leave a medical practice. If you have questions regarding this blog post or have any questions regarding closing your medical practice you may contact us at (404) 685-1662 (Atlanta office), (706) 722-7886 (Augusta office), or info@littlehealthlaw.com.

*Disclaimer: Thoughts shared here do not constitute legal advice.