Endgame strategy

How to close your practice effectively, leaving nothing to chance.

Question: I am shutting down my practice and retiring. What do I need to do?

Answer:

1. Ninety days prior to closing the practice, let your staff know that you’re closing and Advise them on how the office will be staffed during the transition period and what support, if any, you will provide.
2. Sixty days prior to closing the practice, give written notice to your patients (and their legal representatives), of the Send notice by registered mail with a return receipt requested for those patients who are high-risk, undergoing aggressive treatment, or are on your follow-up schedule.
3. The letter should state that your practice is closing and that the patient will have to seek care Include a medical record release authorization form that states the number of years the patient’s records will be retained, and a permanent mailing address or post office box number for future record requests. Offer to provide referrals to other providers. Place a copy of the notice in each patient’s medical record.
4. Send notice of the closure to all health plan carriers, hospitals, professional liability insurance and other insurance carriers, as well as appropriate licensing agencies and professional
5. Create a procedure by which patients can either obtain a copy of their records or have those records transferred to another Do not charge a fee for copying the records if they will be used for purposes of continuing treatment or care.
6. Publish a notice in a newspaper of general circulation that describes the procedure for your patients to obtain their Repeat this notice at least once a month for the first three months after you close your practice.
7. Arrange for preserving and maintaining medical Your agreement with the custodian of patient records must be in writing because verbal agreements cannot be relied on. The agreement should include the following information and terms:

• The custodian must guarantee future access to the records for both the physician and the Patients may only be given a copy of their record. The custodian’s responsibility in maintaining the original records will continue until otherwise provided for in the custodial agreement. Patients should be charged for copies in accordance with state law.
• The fees, if any, to act as custodian must be clearly
• Records that must continue to be retained may be scanned or stored in a secure location that is moisture and fire If the records have surpassed your state’s retention period, they can be destroyed. (Shredding is the preferred method.)
• There should be no right to access the information contained in the medical records without a signed release from the patient or properly executed subpoena or court If the new custodian is a hospital or physician, then records may be accessed for treatment purposes only.
• In the event that the custodian relocates, goes out of business, or changes any contact information, the original physician or the physician’s personal representative must be
• The agreement must describe a method by which decisions will be made on how to ensure the safety of, and continued access to, the
• The state and federal laws governing medical record confidentiality, access, and disclosure (HIPAA), should be stated in the custodial
• Your patients must be advised as to who the custodian is and how they can access their

8. Determine your exposure to malpractice issues and cancel your malpractice insurance For example, under an occurrence policy, notify your carrier in writing and ask for a return of your unearned premium. If you have a claims-made policy, get tail coverage to provide continuing protection if you’re sued in the future for a service that was rendered while the policy was in force.
9. Pay bills, maintain billing and collection activities, and start the process of dissolving your corporate
10. Sixty days prior to closing, stop accepting new patients; start referring patients who require continual follow- up; and start restricting non-emergent appointments if
11. Billing and collection activities generally continue well after the practice has Try to bill and collect as quickly as possible and resolve any outstanding reimbursement issues with insurance companies and patients. If using an outside billing service, check your contract and decide when to cease activities. If billing is done internally, there are several alternatives, including but not limited to:

• Leasing a small office (on a month- to-month basis) so that the necessary staff can continue to work on accounts,
• Having the biller work from home or from the physician’s home,
• Engaging a billing service to work the accounts and take a
• Finding a company that will purchase the receivables (assuming that the receivables are not Medicare or Medicaid, which may not be sold).

12. Inventory your supplies and get an appraisal of your furniture and Your accountant can help you decide what to sell and what to donate by explaining the tax implications of any decision.
13. If equipment is leased, contact the vendor to negotiate the terms for the remaining
14. Notify supply vendors so that they can adjust recurring orders and assign a termination Office supplies with the practice’s name or other identifying information should be destroyed.
15. If you have an integrated practice:

• Be especially careful to destroy prescription
• Follow the federal guidelines for disposing of prescription drugs and
• Contact drug representatives to determine what to do with any unused
• Notify the applicable licensing boards and the Drug Enforcement Administration (for controlled substances).

16. Have your accountant formally dissolve your practice.

 

Deborah Green, Esq., practices law in New York and Florida and has been a practicing attorney since 1977. If you have any questions concerning this article or other legal healthcare issues, she can be contacted at dgreen@healthcarelawcenter.com or through healthcarelawcenter.com.

DISCLAIMER: This column is provided for educational purposes only. The information presented is not as legal advice and no attorney-client relationship is hereby established.