by Gerald Zarlengo, MD, Chairman & CEO, COPIC Insurance Company

COPIC prides itself on establishing life-long relationships with physicians. From our involvement with medical resident programs to helping navigate challenges throughout your career, we stand ready to offer trusted support. This includes helping physicians plan for retirement.

Retirement takes considerable thought, and once the decision is made, you must address business and regulatory aspects. To that end, we’ve created a Retirement Checklist that will help guide you through the process of taking the next step on your life’s journey.

PATIENTS

Patients seen within two years of the provider’s retirement should receive notice a minimum of 30 days and ideally, 60-90 days prior to discontinuing practice. The notice letter should inform patients of the specific date of retirement and the closure of the practice, if applicable. It should also notify the patient to immediately seek a new health care provider. Direct them to their health insurer. For patients who will need continuing care, you may want to refer them to a specific provider. In addition to sending the notice by mail, post the notice at your practice location, perhaps near where patients check in. Provide notice on your website and on your practice’s social media accounts.

INSURANCE CARRIERS

Advise your professional liability carrier of the practice’s closing date or the date you will stop practicing. If you have a claims-made policy, arrange for tail coverage for any claims that are brought after the date you cease practicing. If you are fully retiring, you may qualify for tail coverage at no charge (contact your COPIC underwriter for more details). Business interruption, general liability, employment practices liability, and any other insurance carriers for your business will also need to be notified. If you offer insurance to your employees, notify any health, disability, life, and long-term care insurers and terminate those policies.

STATE MEDICAL BOARD OR LICENSING AGENCY

Some states have retired or inactive license categories that may save you money should you wish to renew your license after retirement. You may also need to update your contact information if the board has your business address and phone number on file.

HEALTH INSURANCE CARRIERS AND OTHER PAYERS

Review the provider contract termination provisions. Often 90 days’ advance notice is required to terminate agreements with private payers. Medicare, Medicaid, TRICARE, and workers’ compensation payers must also be notified of your practice closure.

DRUG ENFORCEMENT AGENCY (DEA)

A DEA number may be kept active after retirement and be needed if you plan to do volunteer medical services. Caveat: Prescribing or treating friends and family is a bad idea when actively practicing; it is more perilous after retirement. When the DEA number is no longer needed, the DEA must be notified in writing and informed that you do not have any schedule II or controlled substances in your possession. The letter must be signed by the retiring physician and the DEA certificate returned with the letter.

You will also need to properly dispose of, transfer, or donate prescription drugs or drug samples that may be on hand in accordance with DEA requirements. Shred any prescription pads upon the closure of the practice. Check www.dea.gov for more details on requirements.

FACILITIES

Advise any hospitals, ambulatory surgery centers, or other facilities that have granted privileges.

MEDICAL RECORDS CHECKLIST    

Arrange for secure medical record storage and access.

Many states have medical record retention requirements that do not cease when a physician retires. Medicare and Medicaid also have requirements. HIPAA privacy and security rules continue to apply after you close your practice. COPIC recommends you retain the medical records for 10 years after the date of last treatment or 10 years after a minor patient reaches the age of majority. If the practice is sold to another physician, physician group, or hospital system, medical records can be included in the purchase as an asset. However, the retiring physician will need to include in the contract the buyer’s obligation to secure the records, ensure patients have access, and that the retiring physician will have access in the event of a lawsuit or audit. If the practice is not sold, consider arranging for another physician or organization to securely store your records and provide timely access for patient requests. Record management companies can provide these services for a cost. Remember that you may need to execute a HIPAA business associate agreement with the party storing your records (unless transferred as part of a sale of the practice).

Arrange for storage of other records.

HIPAA requires that you retain a variety of records (other than medical records) for six years. This includes authorization forms, business associate agreements, notice of privacy practices, responses to requests to amend a record, any patient statements of disagreement, and complaint information.

Plan for the (eventual) destruction of records.

Any records that do not have to be retained under the law that have passed the recommended retention period may be destroyed. Plan to periodically (yearly or biannually) destroy additional records which have passed the required retention periods. If the records contain medical or financial information, the records should be securely shredded. A HIPAA business associate agreement with the file destruction company is required.

The information in this article is for general educational purposes and is not intended to establish practice guidelines or provide legal advice.


Categories: Communications, Colorado Medicine, COPIC Comment