Medical Practice Closure Considerations

We receive questions concerning the steps that are required or necessary in connection with the closure of a medical practice.  Typically, a physician who has devoted their entire life to the day-to-day practice of medicine is faced with numerous legal, accounting, and administrative tasks, some of which extend beyond the actual shut-down of the practice.  Planning, organization, communication, and administration are key elements to avoid issues after the closure.

Practice closure matters include but are not limited to:

Staff Notification: Staff of the practice should be notified of the closure.  A physician may have to prepare to hire temporary staff if employees leave prior to closing date.

Patient Notification: The State Medical Board of Ohio (“Ohio Medical Board”) has laws and rules pertaining to the notice that a physician is required to give patients.  These laws and rules include, but are not limited to, when notice must be given, the information that is required to be included in the notice, and how notice must be given.

Government/Payor/Agency Notifications: Notice concerning the closure of the practice must be coordinated and given to entities including, but not limited to, the DEA, Medicare, Medicaid, private insurance payors, hospitals, professional associations, and the Ohio Medical Board.  Each entity may have different requirements.

Professional Liability Insurance: If necessary, extended reporting professional liability insurance (so called, “tail coverage”) should be obtained, which provides coverage against claims reported after the liability policy expires.

Medical Records: The storage or transfer of paper and electronic medical records in compliance with Federal and State law including, but not limited to, HIPAA must be completed.  An address or PO Box to receive, and procedure to respond to, medical records requests after the closure of the medical practice must be established and followed.

Service and Supply Providers: Notice concerning the closure of the practice to providers including, but not limited to, providers of ancillary services, medical supplies, and other services and supplies should be coordinated and given.  Accounts with such providers should be closed.

Business Entity Issues: Termination of any Lease Agreement(s), termination of utilities services, collection of accounts receivables, sale of medical and office equipment, dissolving the medical practice legal entity with the Ohio Secretary of State, and filing of final Federal, State, and local tax returns must be coordinated and completed.

If you have any questions about this blog or the State Medical Board of Ohio, please feel free to contact one of the attorneys at Collis Law Group LLC at (614) 486-3909 or email me at Todd@collislaw.com.

Ohio physicians: Suspension of your medical license may be just the start of your troubles

The State Medical Board of Ohio has the authority to take a disciplinary action against a physician’s professional license ranging from a Public Reprimand, to suspension, probation, or revocation. In addition, as noted in a previous post, effective September 29, 2015, the Medical Board was granted the authority by the Ohio General Assembly to issue a monetary fine against physicians (or Physician Assistants) found to be in violation of the Medical Practice Act (R.C. 4730 &4731). (See January 11, 2017 blog post about monetary fines).

In addition to a Medical Board disciplinary action, physicians should also be aware that if they are subjected to discipline by the Medical Board, they may also face additional repercussions to their professional practice and livelihood including, but not limited to:

Public Record: All final actions of the Medical Board constitute a public record. The general public will be able to review a summary of the disciplinary action and a copy of the Notice of Opportunity for Hearing, Consent Agreement, or Adjudication Order with Report and Recommendation at the e-license verification page located at: https://elicense.ohio.gov/OH_HomePage.
NPDB: Disciplinary actions of the Medical Board are reported to the National Practitioner Data Bank (NPDB). While the NPDB is not available to the general public, the following eligible entities have access to information on the NPDB: The Department of Health and Human Services, hospitals, health centers, health plans, medical malpractice payors, and state licensing boards. A health care organization can run a continuous query on practitioner reports. Therefore, as soon as you receive discipline from the Board, it is likely your employer will learn about it.
DEA action: A physician’s Drug Enforcement Administration (DEA) license will be suspended during any period of medical licensure suspension. Criminal fines and/or imprisonment are available for any person who knowingly or intentionally (i) possesses a listed chemical with the intent to manufacture a controlled substance without proper registration; (ii) possesses or distributes a listed chemical with knowledge or a reasonable belief that the listed chemical will be used to manufacture a controlled substance; or (iii) evades the Controlled Substance Act’s recordkeeping and reporting requirements by receiving or distributing listed chemicals in small units. Violators of the aforementioned provisions may also be enjoined for up to ten years from handling listed chemicals. The physician must apply to have the DEA reinstated after his or her medical license is reinstated;
Hospital Privileges: Hospital privileges could be suspended or revoked;
Board certifications: Board certifications that the physician has may be limited, suspended, or revoked;
Sister State Discipline: Other state medical boards in which the physician is licensed can institute disciplinary actions based on the Ohio matter;
Medicare/Medicaid participation: A physician’s participation as a Medicaid/Medicare provider may be subject to revocation, thereby excluding them from obtaining reimbursement for services rendered to Medicare/Medicaid patients;
Third Party Payors (Insurance Company participation): Participation as an approved provider for private insurer(s) could be terminated, thereby excluding the physician from obtaining reimbursement for services rendered to patients insured by such insurer(s); and
Bureau of Worker’s Compensation: The BWC can revoke a physician’s certification in the Health Partnership Program—where they participate in a managed-care program for injured workers—if the provider has a misdemeanor committed in the course of practice, involving moral turpitude, or a conviction that is either a felony, cited under the Controlled Substances Act, or is an act involving dishonesty, fraud or misrepresentation. OAC 4123-6-02.2(B)(5).

While each case is different and each physician who is subjected to a disciplinary action by the Medical Board may not be subject to any or all of these additional actions, it is important to understand and appreciate that a Medical Board action may not be the end of the issues that a physician faces when subjected to a Medical Board disciplinary action.

As always, if you have any questions about this post or the State Medical Board of Ohio in general, please feel free to contact one of the attorneys at the Collis Law Group at (614) 486-3909 or email me: Beth@collislaw.com.