Ohio Admin. Code 4731-27-02 - Dismissing a patient from the medical practice
A physician-patient relationship is established when the physician provides service to a person to address medical needs, whether the service was provided by mutual consent or implied consent, or was provided without consent pursuant to a court order. Once a physician-patient relationship is established, a person remains a patient until the relationship is terminated.
(A) Except as provided
in paragraph (B) of this rule, a physician shall comply with the following
requirements in order to dismiss a patient from the medical practice:
(1) Send notice to the patient that includes
all of the following:
(a) A statement that the
physician-patient relationship is terminated;
(b)
A
Except where the patient, or patient's repressentative,
has displayed disruptive or threatening behavior toward the physician, office
staff, or other patients, statement that the physician will continue to
provide emergency treatment and access to services for up to thirty days from
the date the letter was mailed, to allow the patient to secure care from
another licensee; and
(c) An offer
to transfer records to a new provider upon the patient's signed authorization
to do so.
(2) The notice
shall be sent in one of the following ways:
(a) A letter sent via certified mail, return
receipt requested, to the last address for the patient on record, with a copy
of the letter, the certified mail receipt, and the mail delivery receipt
maintained in the patient record;
(b) An electronic message sent via a HIPAA
compliant electronic medical record system or HIPAA compliant electronic health
record system that provides a means of electronic communication between the
health care entity and the patient, is capable of sending the patient a
notification that a message has been received and is in the patient's portal,
and is capable of notifying the sender that a message has not been viewed or
has been viewed;
(c) If a notice
sent via an electronic message as authorized in paragraph (A)(2)(b) of this
rule is not viewed within ten days of having been sent, a letter sent in
accordance with paragraph (A)(2)(a) of this rule.
(B) The requirements of paragraph
(A) of this rule do not apply to the following:
(1) The physician rendered medical service to
the person on an episodic basis or in an emergency setting and the physician
should not reasonably expect that related medical service will be rendered to
the patient in the future;
(2) The
physician formally transferred the patient's care to another health care
provider who is not in the same practice group;
(3) The physician is leaving a practice,
selling a practice, retiring from medical practice, or whose employment with a
health care entity has ended for any reason;
(4) The patient terminated the relationship,
either verbally or in writing, or has transferred care to another physician for
the same or a related condition, and the physician maintains documentation in
the patient record of the patient's action terminating the
relationship.
(C) A
physician assistant or anesthesiologist assistant may not independently dismiss
a patient from a medical practice.
(D) A physician's dismissal of a patient from
a medical practice other than in accordance with the provisions of this rule,
as determined by the state medical board of Ohio, shall constitute "a departure
from, or failure to conform to, minimal standards of care of similar
practitioners under the same or similar circumstances, whether or not actual
injury to a patient is established," as that clause is used in division (B)(6)
of section 4731.22 of the Revised
Code.
(E) Nothing in this rule
shall limit the board's authority to investigate and take action under section
4731.22 of the Revised
Code.
Notes
Promulgated Under: 119.03
Statutory Authority: 4731.05
Rule Amplifies: 4731.22
Prior Effective Dates: 09/30/2006, 12/31/2013
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