Statehouse Update: Patient Notification LegislationThursday, September 13, 2012
The OSMA and the Columbus Medical Association (CMA) met with several lobbyists from the Ohio Hospital Association (OHA), and individual hospitals and health systems to work through the organizations’ differences with House Bill 417, which addresses patient continuity of care notification. The legislation, sponsored by Rep. Cheryl Grossman (R-Grove City), will strengthen Ohio’s protection of the physician-patient relationship and ensure that patients are fully informed when making decisions about the continuity of their medical care.
The bill passed the Ohio House in June by a 96-1 vote and is pending in the Senate Insurance, Commerce and Labor Committee. Hearings are expected to continue after the election with the goal of having the legislation enacted and signed into law by the end of the year.
The bill requires a heath care entity to give notice to patients no later than 10 business days following a physician’s termination of employment with the health care entity. The health care entity may provide the terminated physician with a list of the patients’ contact information that the physician has treated in the past two years so the physician can send the notice to their patients.
Under current law, Ohio Administrative Code 4731-27-01 requires physicians to notify their patients within 30 days of the last date the physician will see patients when a physician is terminating the physician-patient relationship, leaving, selling or retiring from practice. The required notices shall advise patients of their opportunity to transfer or receive their records and the contact information for obtaining the records.
A violation of the notification rules constitutes a minimal standard of care violation, and if reasonable notice is not given, and the patient suffers damages as a result, the physician may be liable for abandonment.
The current law does not address notification requirements when the employment relationship is terminated outside of the physician’s control. In this situation, the physician no longer has access to patient records to comply with the notification requirements and therefore may be subject to disciplinary and civil action.
The hospitals submitted a number of proposed amendments, including expanding the compliance period from 10 business days to 30 days and only providing the physician’s contact information upon request of the patient. While there were several other issues agreed upon, these two issues remain unresolved.
The OSMA and CMA have long supported that patient notification should be provided in the most expeditious manner as possible. The hospitals have argued that the current 10 business day time period will be very difficult to comply with in certain situations and should be expanded to 30 days in order to accommodate those rare instances. Some hospitals have publicly stated that notification period of 10 business days is acceptable and compliance would not be a problem. The groups agreed to continue to discuss a compromise position on the timeline for notification.
In regard to the OHA’s proposed change that would only require disclosure of the physicians contact information upon request of the patient, the OSMA and CMA objected to this change. The OHA expressed concerns that the existing provision could assist in violating non-compete clauses and may require hospitals to provide contact information for physicians who are in the hospital’s peer review process or possible referral to the Medical Board for quality of care concerns.
The OSMA and CMA objections were based on concerns that this would create lack of uniformity in disclosure and has the potential of introducing uncertainty and subjectivity into the notification requirements. The goal of this legislation is to ensure the patient has all available information for them to make an informed decision about their medical care. We believe this provision will best enable the facilitation of that information in a uniform and consistent manner.
The OSMA and CMA agreed to remove the express language that provided a right to action in equity in order to enforce compliance with the law, clarification language exempting medical residents, fellows and interns and an exemption for physicians who move from an employed relationship to an independent contractor status.
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