By Daniel Zinsmaster, Esq. – Ohio law has undergone a number of developments concerning the appropriate means of notifying patients when a physician leaves a practice, as well as the proper steps for terminating a patient from a medical practice. Effective March 22, 2013, health care entities were required to advise patients when an employed physician left the entity or medical practice, regardless of whether the physician’s departure was a result of the employer’s or the practitioner’s decision (Ohio Revised Code Section 4731.228). Now, administrative rules recently amended or adopted by the State Medical Board of Ohio (“Board”) attempt to provide further clarity to this requirement, as well as outline the necessary steps for discharging or terminating an individual patient from a medical practice.

Effective December 31, 2013, any physician leaving, selling or retiring from a practice must comply with Ohio Administrative Code Rule 4731-27-03. Within 30 days of learning of a physician’s termination or resignation, a medical practice must send notice by mail or by HIPAA-compliant electronic means to all patients treated by the departing physician within the past two years. A medical practice may transfer this notification mandate to the departing physician by providing a list of patients treated along with patient contact information to the physician.

The notice to patients must contain all of the following:

• A statement that the physician will no longer be practicing at the health care entity,
• The date the physician ceased or will cease providing services at the health care entity,
• If the physician will be practicing at another location, the contact information for the physician’s new location,
• Contact information for alternative physicians at the health care entity who can provide care to the patient, and
• Contact information so the patient may acquire their medical records.

 The notification requirements do not apply to physicians who have provided treatment on an episodic basis, in an emergency department setting, or at an urgent care center. Notice is not required to patients treated by medical residents, interns and fellows. Furthermore, a health care entity is not required to provide contact information for the physician’s subsequent location when a good faith concern exists regarding patient safety.

In terms of the discharge or termination of a patient from a medical practice, the physician must send notice by certified mail, return receipt request, or by HIPAA-complaint electronic means to the patient. If the electronic communication is not viewed within ten days by the patient, notice by certified mail must be provided. The notice must state that the physician-patient relationship has been terminated, that the physician will provide emergency care and access to services for up to 30 days, and that the patient’s medical records will be available to transfer to another provider. The physician is not obligated to aid or assist the patient in acquisition of a new provider.

Similar to an individual physician’s departure from a health care entity, a physician is not required nor expected to provide notice of formal termination if the physician treated the patient in an emergency setting or on an episodic basis. Moreover, notice of termination is not necessary if the patient’s care has been formally transferred to another physician who is not within the same medical practice, or when the patient is the person responsible for terminating the physician-patient relationship. Nonetheless, such events should be documented in the patient’s chart.

Ohio physicians must also be cognizant that ethical mandates published by the American Medical Association and the American Osteopathic Association similarly prohibit patient abandonment, and set forth appropriate steps for ending physician-patient relationships. Breach of statute, administrative rule or ethical code may expose a physician to professional licensure sanction by the Board and other entities. In light of this evolving area of health care regulation, medical practices and individual physicians must be mindful of the specific notification mandates when an established physician-patient relationship is concluded.

Daniel Zinsmaster is an associate with the Columbus office of Dinsmore & Shohl, LLP.