Medicare Compliance & Reimbursement - 2011 Issue 18
Compliance: Are You Considering 'Firing' A Patient? Proceed Carefully to Avoid Getting Burned
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Article Overview
This article reviews compliance considerations for practices that are thinking about ending a physician-patient relationship. It focuses on legal and operational issues such as notice procedures, state-specific requirements, helping patients transition to other care, participation agreement constraints, and avoiding abandonment concerns. It is written for physicians, practice managers, compliance staff, and others involved in patient dismissal policies.
Why This Topic Matters
Patient discharge decisions can create legal exposure if handled improperly. The article helps practices understand the broad compliance factors that affect whether and how a patient relationship may be ended.
Article Sections
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At issue
Introduces the circumstances that may lead a practice to consider ending a patient relationship and the compliance concerns that can arise.
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1) Give adequate notice.
Covers general notice-related considerations before a relationship is ended and the importance of allowing time for response and transition.
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2) Help your patients find other resources.
Discusses the need to support patients in locating alternate care resources when a relationship is ending.
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3) Pay attention to state laws.
Addresses state-specific requirements that may apply to patient termination and references examples from different jurisdictions.
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4) Pay attention to circumstances.
Notes that patient location, access to providers, and coverage limitations can affect the transition process.
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5) Check your participation agreement.
Explains that contractual terms with health plans may affect how a participating provider handles patient termination.
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Important:
Highlights an additional caution involving Medicare patients and discriminatory discharge concerns.
What You Will Learn
- The compliance issues involved in ending a physician-patient relationship
- How notice and transition planning factor into patient discharge decisions
- Why state law and contractual obligations matter when dismissing a patient
- What operational circumstances can affect the timing of a termination
- How patient status with a health plan may influence discharge procedures
Who Should Read This
- Physicians
- Practice managers
- Compliance professionals
- Medical office administrators
- Health care attorneys
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