Philadelphia Medicine Summer 2020 - 27
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The Centers for Medicare & Medicaid Services (CMS) requires
certain physicians and other eligible professionals to enroll in the
Medicare program, via a CMS-855O application, for the sole purpose
of ordering or certifying items or services for Medicare beneficiaries,
and prescribing Part D drugs.
Are active-retired licensees required to maintain
professional liability insurance?
Medical record distribution
Retention Requirements & Record Ownership: Medical records
must be retained in compliance with Pennsylvania law regardless of
whether the physician who created the records retires, passes away,
or closes their practice. In Pennsylvania, physicians must retain an
adult patient's medical records for at least seven years from the last
date of service.
The Mcare Act requires physicians actively practicing in PennsylRequirements differ slightly for minor patients. The State Board
vania to maintain certain amounts of medical professional liability of Medicine requires MDs to retain a minor patient's medical records
insurance and contribute to the Mcare Fund. However, under the for at least seven years after the last date of service or one year after
Mcare Act, active-retired licensees are exempted from this requirement the patient's eighteenth birthday, whichever is longer. The State
and are not required to maintain liability insurance or participate in Board of Osteopathic Medicine requires DOs to retain a minor
the Mcare Fund as directed under the Act. Physicians should notify patient's medical records for at least seven years after the last date
the Pennsylvania Insurance Department's Mcare Compliance Unit of service or two years after the patient's eighteenth birthday, again
when they go on active-retired status. If physicians do not notify whichever is longer.
the Compliance Unit when they transition to active-retired status,
The physician or practice who maintains the medical records is
the Department will think that they are non-compliant with the
generally considered the owner of the records. In a hospital setting,
Mcare Act. Physicians can contact the Mcare Compliance Unit at
however, a patient's medical records are owned by the hospital.
(717) 783-3770, Ext 280. A Mcare Compliance Form will also need
Nevertheless, although patients do not own their medical records,
to be completed to verify Mcare exemption.
per se, patients do have a right to view and copy their records at
Going to inactive status
When your Pennsylvania medical license is inactive, you are no
longer licensed to practice medicine in the state.
It also means that:
* You do not have to complete the biennial application and
required fee to maintain your license.
* You do not have to complete the CME requirements.
* You do not have to complete the mandatory child abuse recognition and reporting training.
* You do not have to maintain medical professional liability
insurance or participate in Mcare.
Medical professional liability insurance
Although no longer practicing, retired physicians still need professional liability protection because claims can be made long after
care has been provided. Physicians considering retirement should
consult with their medical professional liability insurance provider
to ensure that they are protected in their retirement years.
Some medical professional insurance policies have an automatic
extended reporting endorsement (i.e. tail coverage)-a policy obtained
by physicians in active practice that, when continuously covered by
the claims-made policy, will provide automatic tail coverage upon full
retirement. If a physician's existing policy does not already include
tail coverage, their liability insurance carrier is required to offer, for
a period of 60 days, tail coverage upon cancellation, termination,
or nonrenewal of claims-made coverage.
Physicians must purchase tail coverage to comply with state
law, but they are not required to purchase it from their current
malpractice provider; physicians can shop around for alternative
carriers. Mcare instructs that tail coverage should be received within
120 calendar days of the cancellation, termination, or non-renewal
of claims-made coverage.
Disposition of records if a physician retires
Written notice of a physician's impending retirement should be
provided to all of the retiring physician's patients. This notice should
include the date of the physician's retirement and information on
how patients can obtain copies of their medical records or authorize
transfer of their records to a new physician.
If the retiring physician was part of a group practice, the group
may retain the physician's records. However, the practice must provide patients with copies of their records or have records transferred
to a patient's newly chosen physician upon a patient's request for
such. If the retiring physician was a solo practitioner, the physician
may choose to safely store the records themselves. However, if the
physician has sold their practice or patient records will be stored
by another practice, hospital, or other custodian, this information
should also be provided to patients. Patients must be informed the
location of and how they can access their records.
Consider a late career assessment
Research indicates that there can be an inverse relationship
between the number of years that a physician has been in practice
and the quality of care that the physician provides. The Foundation
of the Pennsylvania Medical Society provides assessments through
their LifeGuard Program. One of these is the Late-Career Assessment
measuring clinical skills and providing a mental and physical health
Core assessment components include an independent, objective
measurement of cognitive and physical functioning as well as fine
motor skills. Individuals are welcome to self-refer for this service.
LifeGuard's contact information is 717-909-2590 by phone or email
at info@LifeGuardProgram.com. *
Summer 2020 : Philadelphia Medicine 27
Philadelphia Medicine Summer 2020
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